bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased Glaucoma Case-Finding Through Routine Optical Coherence Tomography in Optometry Practice
Authors: Paul Joseph P. , McGuinness Myra B. , Ashby Benjamin D. , Tan Jeena , Barber Naomi M. , Weisinger Harrison S. , Martin Keith R. , van Wijngaarden Peter , Larsen Peter D. 
Published: November 2023

Précis:
Optometrists employing OCT as a routine clinical tool have a higher chance of referring patients for specialist glaucoma management than those without OCT.

Objective:
Timely detection of glaucoma is key to preventing or delaying vision loss. This study aimed to assess whether the routine use of optical coherence tomography (OCT) by optometrists for the detection of glaucomatous changes in the optic nerve and retina increased glaucoma referrals to ophthalmologists.

Design:
This study was a retrospective review of routinely collected electronic medical records of patients from a chain of 331 optometry practices in Australia.

Participants:
Electronic medical records were reviewed for every patient aged 18–99 years who attended an included practice between January 1 and July 31, 2019.

Methods:
Odds of referral for glaucoma assessment were compared between practices performing OCT routinely on all patients (OCT practices, n=175) and without OCT (non-OCT practices, n=20). A subset of referrals were assessed by ophthalmologists to determine the false positive referral rate.

Main Outcome Measures:
The primary outcome measure of this study was referral to an ophthalmologist for glaucoma assessment. A secondary outcome was the rate of false positive referrals, analyzed in a subset of patients referred for glaucoma assessment.

Results:
Records from 994,461 patients (59% female) were included, and 10,475 (1.1%) were referred for glaucoma assessment. Most referrals were associated with normal intraocular pressure (non-OCT practices: n=496, 66%; OCT practices: n=6,603, 68%). Referral for glaucoma was higher in OCT practices (n=9,719, 1.1%) compared with non-OCT practices (n=756, 0.8%, age-adjusted, gender-adjusted, and location-adjusted odds ratio 1.39, 95% confidence interval 1.10–1.76). Of 318 referred patients (3%, all from OCT practices) for whom ophthalmologist feedback was available, 68 (21%) were considered not to have glaucoma.

Conclusions:
The routine use of OCT in optometric practice may lead to more timely glaucoma detection and prevention of avoidable vision loss.
Comparison of Structural and Functional Features in Primary Angle Closure and Open Angle Glaucomas
Authors: Sun Jessica A. , Yuan Melissa , Johnson Grace E. , Pasquale Louis R. , Boland Michael V. , Friedman David S. , Elze Tobias , Shen Lucy Q. , Wang Mengyu 
Published: November 2023

Précis:
Using a large data set, we showed structural and functional differences between primary angle closure glaucoma (PACG) and primary open angle glaucoma (POAG). Primary angle closure glaucoma has relative structural preservation and worse functional loss inferiorly.

Purpose:
To identify structural and functional differences in PACG and POAG.

Materials and Methods:
In this large cross-sectional study, differences in structural and functional damage were assessed among patients with POAG and PACG with optical coherence tomography and reliable visual field testing.

Results:
In all, 283 patients with PACG and 4110 patients with POAG were included. Despite similar mean deviation on visual fields (mean [SD] –7.73 [7.92] vs. –7.53 [6.90] dB, P=0.72), patients with PACG had thicker global retinal nerve fiber layer (RNFL), smaller cup volume, smaller cup-to-disc ratio, and larger rim area than POAG (77 [20] vs. 71 [14] µm, 0.32 [0.28] vs. 0.40 [0.29] mm3, 0.6 [0.2] vs. 0.7 [0.1], 1.07 [0.40] vs. 0.89 [0.30] mm2, P<0.001 for all), while patients with POAG had more pronounced inferior RNFL thinning (82 [24] vs. 95 [35] µm, P<0.001). In a multivariable analysis, hyperopia [odds ratio (OR): 1.24, confidence interval (CI): 1.13–1.37], smaller cup-to-disc ratio (OR: 0.69, CI: 0.61–0.78), thicker inferior RNFL (OR: 1.15, CI: 1.06–1.26) and worse mean deviation (OR: 0.95, CI: 0.92–0.98) were associated with PACG. Functionally, POAG was associated with superior paracentral loss and PACG with inferior field loss. After adjusting for average RNFL thickness, PACG was associated with more diffuse loss than POAG (total deviation differences 1.26–3.2 dB).

Conclusions:
Patients with PACG had less structural damage than patients with POAG despite similar degrees of functional loss. Regional differences in patterns of functional and structural loss between POAG and PACG may improve disease monitoring for these glaucoma subtypes.
The Safety and Efficacy of Using Uremic Clearance Granules for Treating Stages 3 to 5 of Chronic Kidney Disease: A Meta-analysis
Authors: Yin Jiazhen , Chen Hongyu , Zhu Bin 
Published: November 2023

ABSTRACT

Background:
To evaluate the effectiveness and safety of uremic clearance granules for treating stages 3 to 5 of chronic kidney disease (CKD), and to provide evidence-based support for the clinical application of uremic clearance.

Methods:
All randomized controlled trials (RCTs) addressing the use of uremic clearance granules for the treatment of CKD were collected from China Biology Medicine (CBM) database, China National Knowledge Infrastructure (CNKI), WanFang Data, PubMed, Cochrane Library, and Web of Science. After two researchers had independently screened and extracted data, the quality of the included literature was evaluated according to the modified Jadad rating scale. Finally, Stata11 was used for the meta analysis.

Results:
A total of 36 RCTs were obtained that included 3058 patients, comprising 1538 experimental group and 1520 control group participants. Meta analysis indicated that uremic clearance granules treatment yielded promising results in lowering the levels of serum creatinine (Scr, weekly hemodialysis [WHD] = −52.42, 95% confidence interval [CI]: −62.64 to −42.21), triglyceride (TG, WHD = −0.45, 95% CI: −0.85 to −0.04), total cholesterol (TC, WHD = −1.41, 95% CI: −1.78 to −1.04) and increasing the glomerular filtration rate (GFR, WHD = 3.26, 95% CI: 3.70 to 6.99) and hemoglobin (HB, WHD = 5.79, 95% CI: 2.66 to 8.92) levels. In addition, this treatment can improve the overall signs and symptoms of patients with CKD [relative risk (RR) = 1.37, 95% CI: 1.24 to 1.51]. However, there was no statistically significant reduction in the 24 hours total urine protein (24hUpro) Hb levels (WHD = −194.95, 95% Cl: −425.92 to 36.01) compared with control therapy alone.

Conclusion:
Uremic clearance granules treatment significantly reduced Scr, TG, TC levels and increased GFR and HB levels while improving the signs and symptoms of patients with CKD. Due to the low quality of the methodological approaches used in the included studies, further high quality research initiatives are needed to further explore the merits of this therapy.
Prevalence and Correlates of Serotonin Syndrome in Real-World Inpatients
Authors: Di Salvo Gabriele , Porceddu Giorgia , Perotti Camilla , Maina Giuseppe , Rosso Gianluca 
Published: November 2023

AbstractBackgroundSerotonin syndrome (SS) is a potentially life-threatening adverse drug reaction due to an increased central and peripheral serotonin activity, which usually presents as a triad of behavioral changes, neuromuscular excitability, and autonomic instability. Probably SS is often misdiagnosed, and its symptoms are mistaken for psychiatric symptoms or general medical issues: the true incidence of SS is not clear, and literature concerning potential risk factors is scarce. Our aims were to examine the prevalence of SS in a naturalistic sample of hospitalized patients and to evaluate potential factors related to the risk of developing the condition.MethodsThe sample included 133 patients being treated with serotonergic medications admitted to the psychiatric inpatient unit of the San Luigi Gonzaga Hospital. All patients received a medical examination (including a neurological examination) within 24 hours of admission. Serotonin syndrome was diagnosed according to Hunter Criteria.ResultsSixteen patients (12%) were diagnosed with SS. In the subgroup of subjects with SS, we found a higher rate of male patients when compared with subjects with no SS (62.5% vs 33.3%,P= 0.023).ConclusionsSS probably is an underestimated condition, which should be carefully assessed in patients on serotonergic medications. Male gender was the only factor found to be significantly related to a higher risk of developing SS. Further studies on larger samples are needed, to gain more information on possible risk factors and to identify subjects more prone to developing SS, given the potential risk for patients' health.
Relationship Between Anxiety, Coping Strategies, and Perfectionism in Entry-level Doctor of Physical Therapy Students
Authors: Worst Haley , Adams Katherine , Thompson Anne 
Published: November 2023

Introduction.
Doctor of Physical Therapy (DPT) students must meet high standards throughout their lives and careers, which can cause stress and anxiety, with potentially devastating impacts. This quantitative study examined whether and to what extent perfectionism, demographic characteristics, and coping strategies relate to state (situation-related) and trait (personality-related) anxiety in DPT students.

Review of Literature.
Existing literature demonstrates high anxiety levels in DPT students; also, maladaptive perfectionism is associated with higher levels of stress. The predictive relationship between coping, perfectionism, and anxiety in DPT students has not been assessed.

Subjects.
Convenience sample of DPT students in their first through third years across 8 different DPT programs (n = 206).

Methods.
This paper was a cross-sectional, nonexperimental, multisite project. A hierarchical linear regression assessed the relationship between variables (demographics, coping, perfectionism, state anxiety, and trait anxiety).

Results.
Approximately 81.5% of the sample reported being not a perfectionist, 7.0% maladaptive perfectionists, and 11.5% adaptive perfectionists. Students using adaptive coping comprised 72.3% of the sample, whereas 28.0% used primarily maladaptive coping mechanisms. State Trait Anxiety Inventory scores were higher for this sample of DPT students when compared with published studies in the normal population. Significant predictor variables for state anxiety were sex, type of coping strategies used, and class year in the DPT program. For trait anxiety, sex, coping strategy type, maladaptive perfectionism, and class year were significant.

Discussion and Conclusion.
There is a predictive relationship between sex, type of coping strategies used, and year within the DPT program for both state and trait anxiety in DPT students. Presence of maladaptive perfectionism was an additional predictive variable for trait anxiety. This knowledge can help educational institutions better identify at-risk students for anxiety and tailor programs to better meet the individual needs of our students.
Cross-Cultural Validation of the TeamSTEPPS Teamwork Perceptions Questionnaire-Spanish in Colombia
Authors: Amaya-Arias Ana C. , García-Valencia Jenny , Jaimes Fabián 
Published: November 2023

Background:
Teamwork influences health care quality and patient safety. Yet, validated instruments for assessing teamwork in Colombia are lacking.

Purpose:
The purpose of this study was to validate the Spanish version of the TeamSTEPPS-Teamwork Perceptions Questionnaire (T-TPQ-S) for the Colombian health care context.

Methods:
The T-TPQ-S underwent translation, cultural adaptation, and comprehensive psychometric testing, including reliability and confirmatory factor analyses and item difficulty and discrimination analyses.

Results:
The T-TPQ-S demonstrated high internal consistency and excellent fit to the theoretical model. Item discrimination was within expected ranges, with response thresholds displaying an ascending order. The tool better differentiated subjects with low and high teamwork perceptions.

Conclusions:
The T-TPQ-S is an effective, reliable, and valid instrument for assessing teamwork perception among Colombian health care workers.
Implementing Tai Chi Exercise in Long-Term Care to Reduce Falls
Authors: Miles Angela F. , Mulkey David C. 
Published: November 2023

Background:
Falls are a frequent occurrence in older adults in long-term care facilities.

Local Problem:
At our long-term care facility, the percentage of patients who fell increased from 45% in 2021 to 68% in 2022, indicating a need for an evidence-based solution.

Methods:
We used an evidence-based quality improvement framework to pilot a tai chi exercise program.

Interventions:
Residents were invited to participate in the Tai Ji Quan: Moving for Better Balance program for 12 weeks. Classes were 30 minutes long and included a 5-minute warm-up and 5-minute cooldown.

Results:
Seventy-five residents participated in the tai chi program. There was a significant 32.3% reduction in falls (P =.001). Residents' fall risk scores decreased 14% (P < .001).

Conclusions:
Implementing a tai chi exercise project may affect falls and decrease the overall fall risk.
The Use of Medical Chaperones During Physical Examinations
Authors: Wilson Meghan , Patel Seema M. , Langhan Melissa L. 
Published: November 2023

Purpose
A medical chaperone serves as a witness for a patient and health care practitioner during a medical examination. We sought to better understand the preferences of parents and children toward the use of chaperones during pediatric physical examinations.

Methods
This cross-sectional study surveyed patients aged 8 to 18 years and their parents presenting primarily to the emergency department as well as primary care ambulatory clinic and inpatient units. Participants were asked which individuals (patient alone, parent, or medical chaperone) should be present for each aspect of the child's physical examination.

Results
The survey was completed by 121 patients (mean age 14 years, 58.5% girls) and 122 parents (mean age 42 years, 82.8% women) in a variety of clinical settings (17 in inpatient, 17 in outpatient clinic, and 87 emergency department admissions). Significant differences existed between male and female patients regarding preferred presence for every body part being examined (P ≤ 0.002). Female patients preferred to have a same-sex parent in the room, particularly for examination of the breasts, genitalia, or rectum and when the examination was performed by a male provider. Male patients preferred to be alone or with either parent for any body part being examined, regardless of provider sex.

Conclusions
Adolescents have significant differences in who they prefer to be in the room for the physical examination based on patient and provider sex in settings where they are unfamiliar with the health care examiner. Few patients and parents preferred a medical chaperone; most preferred a parent to be in the room. Patient and parent considerations should be prioritized when creating policies for the use of medical chaperones.
The formation of ubiquitin rich condensates triggers recruitment of the ATG9A lipid transfer complex to initiate basal autophagy
Authors: Broadbent DG , McEwan CM , Tsang TM , Poole DM , Naylor BC , Price JC , Schmidt JC , Andersen JL 
Published: November 2023

AbstractAutophagy is an essential cellular recycling process that maintains protein and organelle homeostasis. ATG9A vesicle recruitment is a critical early step in autophagy to initiate autophagosome biogenesis. The mechanisms of ATG9A vesicle recruitment are best understood in the context of starvation-induced non-selective autophagy, whereas less is known about the signals driving ATG9A vesicle recruitment to autophagy initiation sites in the absence of nutrient stress. Here we demonstrate that loss of ATG9A or the lipid transfer protein ATG2 leads to the accumulation of phosphorylated p62 aggregates in the context of basal autophagy. Furthermore, we show that p62 degradation requires the lipid scramblase activity of ATG9A. Lastly, we present evidence that poly-ubiquitin is an essential signal that recruits ATG9A and mediates autophagy foci assembly in nutrient replete cells. Together, our data support a ubiquitin-driven model of ATG9A recruitment and autophagosome formation during basal autophagy.
High resolution long-read telomere sequencing reveals dynamic mechanisms in aging and cancer
Authors: Schmidt Tobias T. , Tyer Carly , Rughani Preeyesh , Haggblom Candy , Jones Jeffrey R. , Dai Xiaoguang , Frazer Kelly A. , Gage Fred H. , Juul Sissel , Hickey Scott , Karlseder Jan 
Published: November 2023

AbstractTelomeres are the protective nucleoprotein structures at the end of linear eukaryotic chromosomes. Telomeres’ repetitive nature and length have traditionally challenged the precise assessment of the composition and length of individual human telomeres. Here, we present Telo-seq to resolve bulk, chromosome arm-specific and allele-specific human telomere lengths using Oxford Nanopore Technologies’ native long-read sequencing. Telo-seq resolves telomere shortening in five population doubling increments and reveals intrasample, chromosome arm-specific, allele-specific telomere length heterogeneity. Telo-seq can reliably discriminate between telomerase- and ALT-positive cancer cell lines. Thus, Telo-seq is a novel tool to study telomere biology during development, aging, and cancer at unprecedented resolution.
Multi-ContrastiveVAE disentangles perturbation effects in single cell images from optical pooled screens
Authors: Wang Zitong Jerry , Lopez Romain , Hütter Jan-Christian , Kudo Takamasa , Yao Heming , Hanslovsky Philipp , Höckendorf Burkhard , Moran Rahul , Richmond David , Regev Aviv 
Published: November 2023

AbstractOptical pooled screens (OPS) enable comprehensive and cost-effective interrogation of gene function by measuring microscopy images of millions of cells across thousands of perturbations. However, the analysis of OPS data still mainly relies on hand-crafted features, even though these are difficult to deploy across complex data sets. This is because most unsupervised feature extraction methods based on neural networks (such as auto-encoders) have difficulty isolating the effect of perturbations from the natural variations across cells and experimental batches. Here, we propose a contrastive analysis framework that can more effectively disentangle the phenotypes caused by perturbation from natural cell-cell heterogeneity present in an unperturbed cell population. We demonstrate this approach by analyzing a large data set of over 30 million cells imaged across more than 5, 000 genetic perturbations, showing that our method significantly outperforms traditional approaches in generating biologically-informative embeddings and mitigating technical artifacts. Furthermore, the interpretable part of our model distinguishes perturbations that generate novel phenotypes from the ones that only shift the distribution of existing phenotypes. Our approach can be readily applied to other small-molecule and genetic perturbation data sets with highly multiplexed images, enhancing the efficiency and precision in identifying and interpreting perturbation-specific phenotypic patterns, paving the way for deeper insights and discoveries in OPS analysis.
Targeting PKC alleviates iron overload in diabetes and hemochromatosis
Authors: Banerjee Somesh , Lu Shaolei , Jain Anand , Wang Irene , Tao Hui , Srinivasan Shanthi , Nemeth Elizabeta , He Peijian 
Published: November 2023

AbstractDiabetes is one of the most prevalent chronic diseases worldwide. Iron overload increases the incidence of diabetes and aggravates diabetic complications that cause mortality. Reciprocally, diabetes potentially promotes body iron loading, but the mechanism remains not well understood. In this study, we demonstrated systemic iron excess and the upregulation of iron exporter ferroportin (Fpn) in the enterocytes and macrophages of multiple diabetic mouse models. Increased Fpn expression and iron efflux was also seen in the enterocytes of type 2 diabetic human patients. We further showed that protein kinase C (PKC), which is activated in hyperglycemia, was responsible for the sustained membrane expression of Fpn in physiological and in diabetic settings. For the first time, we identified that PKCs were novel binding proteins and positive regulators of Fpn. Mechanistically, hyperactive PKC promoted exocytotic membrane insertion while inhibited the endocytic trafficking of Fpn in the resting state. PKC also protected Fpn from internalization and degradation by its ligand hepcidin dependent on decreased ubiquitination and increased phosphorylation of Fpn. Importantly, the loss-of-function and pharmacological inhibition of PKC alleviated systemic iron overload in diabetes and hemochromatosis. Our study thus highlights PKC as a novel target in the control of systemic iron homeostasis.
CHIP is associated with cardiovascular disease in the UK Biobank
Authors: Vlasschaert Caitlyn , Genovese Giulio , Pershad Yash , Jaiswal Siddhartha , Natarajan Pradeep , Bick Alexander G. 
Published: November 2023

AbstractClonal hematopoiesis (CH) is a form of age-related somatic mosaicism. CH encompasses both clonal events with recognizable leukemic driver mutations, such as CH of indeterminate potential (CHIP) and mosaic chromosomal alterations (mCAs), as well as clonal states without clear driver mutations. Staceyet al. identify cases of CH from whole genome sequencing (WGS) data in a subset of 130,709 UK Biobank (UKB) participants and in 45,510 individuals from an Icelandic cohort. They report that CH is not associated with cardiovascular disease (CVD) and posit that the multiple prior CH studies did not fully account for smoking-related confounding. We find that the conclusion reached by Staceyet al. is specific to their particular CH definition which groups well-established and clinically meaningful CH subtypes together despite evidence from multiple previous reports that distinct forms of CH have distinct phenotypic consequences. We show that (1) the CHIP/ CVD association in the UK Biobank is not confounded by smoking and (2) CH subtypes which Staceyet al. have lumped together have heterogenous associations with CVD. We suggest that Stacey et al.’s failure to identify an association between CHIP and CVD is perhaps related to methodologic differences compared to prior reports.