bluuebunny/crossref_metadata_2025_split huggingface dataset:
The sub-critical illusion: synthetic Zeeman effect observations from galactic zoom-in simulations
Authors: Hu Zipeng , Wibking Benjamin D , Krumholz Mark R 
Published: March 2023

ABSTRACT
Mass-to-flux ratios measured via the Zeeman effect suggest the existence of a transition from a magnetically sub-critical state in H i clouds to a supercritical state in molecular clouds. However, due to projection, chemical, and excitation effects, Zeeman measurements are subject to a number of biases, and may not reflect the true relations between gravitational and magnetic energies. In this paper, we carry out simulations of the formation of magnetized molecular clouds, zooming in from an entire galaxy to sub-pc scales, which we post-process to produce synthetic H i and OH Zeeman measurements. The mass-to-flux ratios we recover from the simulated observations show a transition in magnetic criticality that closely matches observations, but we find that the gravitational-magnetic energy ratios on corresponding scales are mostly supercritical, even in the H i regime. We conclude that H i clouds in the process of assembling to form molecular clouds are already supercritical even before H2 forms, and that the apparent transition from sub- to supercriticality between H i and H2 is primarily an illusion created by chemical and excitation biases affecting the Zeeman measurements.
f(R) gravity in the Jordan frame as a paradigm for the Hubble tension
Authors: Schiavone Tiziano , Montani Giovanni , Bombacigno Flavio 
Published: March 2023

ABSTRACT
We analyse the f(R) gravity in the so-called Jordan frame, as implemented to the isotropic Universe dynamics. The goal of the present study is to show that according to recent data analyses of the supernovae Ia Pantheon sample, it is possible to account for an effective redshift dependence of the Hubble constant. This is achieved via the dynamics of a non-minimally coupled scalar field, as it emerges in the f(R) gravity. We face the question both from an analytical and purely numerical point of view, following the same technical paradigm. We arrive to establish that the expected decay of the Hubble constant with the redshift z is ensured by a form of the scalar field potential, which remains essentially constant for z ≲ 0.3, independently if this request is made a priori, as in the analytical approach, or obtained a posteriori, when the numerical procedure is addressed. Thus, we demonstrate that an f(R) dark energy model is able to account for an apparent variation of the Hubble constant due to the rescaling of the Einstein constant by the f(R) scalar mode.
RNA origami scaffolds facilitate cryo-EM characterization of a Broccoli–Pepper aptamer FRET pair
Authors: Sampedro Vallina Néstor , McRae Ewan K S , Hansen Bente Kring , Boussebayle Adrien , Andersen Ebbe Sloth 
Published: March 2023

Abstract
Cryogenic electron microscopy (cryo-EM) is a promising method for characterizing the structure of larger RNA structures and complexes. However, the structure of individual aptamers is difficult to solve by cryo-EM due to their low molecular weight and a high signal-to-noise ratio. By placing RNA aptamers on larger RNA scaffolds, the contrast for cryo-EM can be increased to allow the determination of the tertiary structure of the aptamer. Here we use the RNA origami method to scaffold two fluorescent aptamers (Broccoli and Pepper) in close proximity and show that their cognate fluorophores serve as donor and acceptor for FRET. Next, we use cryo-EM to characterize the structure of the RNA origami with the two aptamers to a resolution of 4.4 Å. By characterizing the aptamers with and without ligand, we identify two distinct modes of ligand binding, which are further supported by selective chemical probing. 3D variability analysis of the cryo-EM data show that the relative position between the two bound fluorophores on the origami fluctuate by only 3.5 Å. Our results demonstrate a general approach for using RNA origami scaffolds for characterizing small RNA motifs by cryo-EM and for positioning functional RNA motifs with high spatial precision.
Implementation, Maintenance, and Outcomes of an Electronic Referral to a Tobacco Quitline Across Five Health Systems
Authors: Tong Elisa K , Zhu Shu-Hong , Anderson Christopher M , Avdalovic Mark V , Amin Alpesh N , Diamant Allison L , Fong Timothy W , Clay Brian , El-Kareh Robert , Sankaran Sujatha , Bonniot Catherine , Kirby Carrie A , Mayoral Antonio , Sarna Linda 
Published: March 2023

AbstractIntroductionElectronic referral (e-referral) to quitlines helps connect tobacco-using patients to free, evidence-based cessation counseling. Little has been published about the real-world implementation of e-referrals across U.S. health systems, their maintenance over time, and the outcomes of e-referred patients.Aims and MethodsBeginning in 2014, the University of California (UC)-wide project called UC Quits scaled up quitline e-referrals and related modifications to clinical workflows from one to five UC health systems. Implementation strategies were used to increase site readiness. Maintenance was supported through ongoing monitoring and quality improvement programs. Data on e-referred patients (n = 20 709) and quitline callers (n = 197 377) were collected from April 2014 to March 2021. Analyses of referral trends and cessation outcomes were conducted in 2021–2022.ResultsOf 20 709 patients referred, the quitline contacted 47.1%, 20.6% completed intake, 15.2% requested counseling, and 10.9% received it. In the 1.5-year implementation phase, 1813 patients were referred. In the 5.5-year maintenance phase, volume was sustained, with 3436 referrals annually on average. Among referred patients completing intake (n = 4264), 46.2% were nonwhite, 58.8% had Medicaid, 58.7% had a chronic disease, and 48.8% had a behavioral health condition. In a sample randomly selected for follow-up, e-referred patients were as likely as general quitline callers to attempt quitting (68.5% vs. 71.4%; p = .23), quit for 30 days (28.3% vs. 26.9%; p = .52), and quit for 6 months (13.6% vs. 13.9%; p = .88).ConclusionsWith a whole-systems approach, quitline e-referrals can be established and sustained across inpatient and outpatient settings with diverse patient populations. Cessation outcomes were similar to those of general quitline callers.ImplicationsThis study supports the broad implementation of tobacco quitline e-referrals in health care. To the best of our knowledge, no other paper has described the implementation of e-referrals across multiple U.S. health systems or how they were sustained over time. Modifying electronic health records systems and clinical workflows to enable and encourage e-referrals, if implemented and maintained appropriately, can be expected to improve patient care, make it easier for clinicians to support patients in quitting, increase the proportion of patients using evidence-based treatment, provide data to assess progress on quality goals, and help meet reporting requirements for tobacco screening and prevention.
Modified National Early Warning Score (MNEWS) in predicting the mortality of intensive care unit patients
Authors: Wang Shengyu , Tian Yao , Yao Yang , Zhou Jing , Chen Hui , Diao Xin 
Published: March 2023

Abstract

Purpose
This study aims to develop an accurate and simplified scoring system based on the national early warning score (NEWS) to predict the mortality of intensive care unit (ICU) patients.

Methods
The information of patients was retrieved from the Medical Information Mart for Intensive Care (MIMIC)-III and -IV databases. The Modified National Early Warning Score (MNEWS) of the patients was calculated. The discrimination ability of the MNEWS, acute physiology and chronic health scoring system II (APACHE II), and original NEWS systems in predicting patients’ mortality was evaluated using area under the receiver operating characteristic (AUROC) analysis. The DeLong test was used to estimate the receiver operating characteristic curve. The Hosmer–Lemeshow goodness-of-fit test was then applied to evaluate the calibration of the MNEWS.

Results
In total, 7275 ICU patients from the MIMIC-III and -IV databases were included in the derivation cohort and 1507 ICU patients from Xi’an Medical University were included in the validation cohort. In the derivation cohort, the nonsurvivors had significantly higher MNEWSs than the survivors (12.5 ± 3.4 vs 8.8 ± 3.4, P &lt; 0.05). MNEWS and APACHE II both had a better performance than the NEWS in predicting hospital mortality and 90-day mortality. The optimal cutoff of MNEWS was 11. Patients with an MNEWS ≥ 11 had significantly shorter survival than those having an MNEWS of &lt;11. Furthermore, MNEWS had a high calibration ability in predicting hospital mortality of ICU patients (χ2 = 6.534 and P = 0.588) by the Hosmer–Lemeshow test. This finding was confirmed in the validation cohort.

Conclusion
MNEWS is a simple and accurate scoring system for evaluating the severity and predicting the outcomes of ICU patients.
Improving access to SLE therapies in low and middle-income countries
Authors: Mendoza-Pinto Claudia , Etchegaray-Morales Ivet , Ugarte-Gil Manuel F 
Published: March 2023

AbstractSLE increases disease burden in those affected with it, and that is particularly the case in low- and middle-income countries. The 2019 Addressing Lupus Pillar of Health Advancement project is a multiphase initiative whose objective is to recognize, hierarchize and establish approaches for diligent SLE research, care and access to healthcare. Lack of access to high-cost medications that have been shown to be efficacious in the short term and that potentially reduce damage in SLE is a complex issue. In this review, we highlight opportunities and plans of action to diminish costs and improve access to therapies, which should be recognized and executed, preferably within regional strategies with multiple stakeholders (including supranational organizations, governments, the pharmaceutical industry, medical societies and the general population) connected with and grounded in structured and clear cost-effectiveness analysis.
Using Our Voice
Authors: Sauda Valerie C. , Bisher Priscilla , Nason Mark 
Published: March 2023

Abstract
The COVID-19 pandemic affected clinical placements for nursing students throughout the United States, especially in rural areas. Public service announcements were created through a collaborative service-learning project between the school of nursing and the university radio station. Baccalaureate nursing students developed and delivered short public service announcements focused on issues of loneliness, stress, and anxiety and provided information about community resources. The alignment of this meaningful project with course learning outcomes gave students exposure to the social determinants of health as well as best practices in mental health outreach.
Cancer Pain and Frailty: A Scoping Review of How Cancer Pain Is Evaluated and Treated in the Frail and Elderly
Authors: McLarney Mitra , Johnson Taylor , Bajaj Gurtej , Lee David , Zheng Jasmine 
Published: March 2023

Background:
Over 50% of individuals with cancer will experience pain at some point from diagnosis to treatment. Many of these individuals are elderly and frail, further complicating their pain management. The purpose of this review is to synthesize what is known about the assessment and management of cancer pain in the frail, elderly individual.

Methods:
A scoping review was undertaken using the methodology outlined by Arksey and O'Malley with reporting as defined by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Three databases were searched for articles that met our inclusion criteria and resulted in a total of 2007 articles of which 6 were ultimately included in our review.

Results:
Of the 6 studies included 5 focused on individual related characteristics and 1 study focused on provider factors. These studies found that frail and elderly individuals with cancer are at risk of unmanaged pain and polypharmacy; however, the prevalence remains unclear. Additionally, treatment of cancer pain in this population is impacted by clinicians' backgrounds and comfort levels in pain assessments.

Discussion:
The frail, elderly individual with cancer is at risk for pain. Little is currently known about how to accurately measure and safely treat pain in this population.
Local Anesthesia Versus General Anesthesia in Percutaneous Interlaminar Endoscopic Discectomy
Authors: Han Lei , Yin Jianjian , Jiang Xijia , Nong Luming 
Published: March 2023

Objective:
The objective of this study was to systematically evaluate the safety and efficacy of local anesthesia (LA) and general anesthesia (GA) in percutaneous interlaminar endoscopic discectomy (PIED).

Materials and Methods:
We searched MEDLINE, EMBASE, EuropePMC, PubMed, Web of Science, Cochrane databases, and CNKI databases for all relevant studies. All statistical analysis was performed using Review Manager version 5.3.

Results:
A total of 6 articles with 549 study participants were included, with 282 patients in LA group and 267 patients in GA group. The results of the meta-analysis showed that the LA group had significantly better results in hospital stay time (mean difference [MD], −1.68; 95% CI, −3.35 to −0.01) and hospital costs (MD, −0.57, 95% CI, −1.02 to −0.12) compared with the GA group; whereas Oswestry Disability Index (MD, 0.48; 95% CI, −0.07 to 1.04), Visual Analog Scale Scores (MD, −0.05; 95% CI, −0.24 to 0.13), postoperative transient dysesthesia and weakness (odds ratio [OR], 0.83, 95% CI, 0.40 to 1.69), dura and nerve root injury (OR, 0.21, 95% CI, 0.03 to 1.25), operation time (MD, −3.51; 95% CI, −11.5 to 4.48), and willingness rate to receive the same procedure(OR, 0.12, 95% CI, 0.01 to 1.00) showed no significant differences between the 2 groups.

Discussion:
LA can effectively relieve pain during PIED surgery and ensure the safety of operation without increasing the occurrence of postoperative complications. PIED under LA not only has similar patient satisfaction but also shows obvious advantages in shortening hospital stay and reducing hospital costs compared with GA surgery.
Systematic Review of the Effectiveness of Allied Health Clinical Education Programs
Authors: Windfeld-Lund Cristie , Sturt Rodney , Pham Carol , Lannin Natasha A. , Graco Marnie 
Published: March 2023

Introduction:
Continuing allied health professional (AHP) clinical education is essential to ensure high-quality patient care; however, the effectiveness of current education programs is unclear. This review aimed to determine whether AHP education programs improve the knowledge of AHPs, change their clinical practice behavior, and/or improve patient-related clinical outcome and to identify important components of these programs.

Methods:
Four electronic databases were searched. Controlled clinical trials investigating the effectiveness of clinical education programs were included. Education programs were diverse, varying in design, delivery mode, and intensity. Only therapy-specific AHPs were included. Effectiveness was determined by differences in group outcomes in the domains of AHP knowledge, AHP clinical practice behavior, and patient-related clinical outcomes.

Results:
Forty-four studies were identified, of which 26 included physiotherapists only. Most control groups were waitlist, passive dissemination of information, or usual care, limiting comparisons between programs. Changes in AHP knowledge was investigated in 20 trials, with 13 showing an improvement. Thirty studies investigated changes in AHP clinical practice behavior, with half demonstrating a difference between groups. Seventeen studies investigated a patient-related clinical outcome, with five finding a difference between groups. Where improvements in outcomes were demonstrated, programs tended to incorporate self-selection and cater to the learner's contextual needs.

Discussion:
AHP knowledge is effectively improved through targeted education programs. To change AHP behavior and patient outcomes, it seems important to incorporate self-selection for the program and consider the learner's individual needs and contexts through mentoring, outreach visits, reflection, and incorporating patient participation in the learning.
Incidence and Timing of Pigment Epithelial Detachment and Subretinal Fluid Development in Type 3 Macular Neovascularization associated with Age-related Macular Degeneration
Authors: Kim Jae Hui , Kim Jong Woo , Kim Chul Gu 
Published: March 2023

ABSTRACT

Purpose:
To evaluate the incidence and timing of pigment epithelial detachment (PED) and subretinal fluid(SRF) development in type 3 macular neovascularization (MNV).

Methods:
This retrospective study included 84 patients who were diagnosed with treatment-naïve type 3 MNV who did not show SRF at diagnosis. All patients were initially treated with three loading injections of ranibizumab or aflibercept. Following the initial loading injections, as-needed regimen was performed for retreatment. The development of either PED or SRF was identified. The incidence and timing of PED development in patients without PED at diagnosis and that of SRF development in patients with PED at diagnosis were evaluated.

Results:
The mean follow-up period was 41.3±20.7 months after diagnosis. Among the 32 patients without serous PED at diagnosis, PED developed in 20 (62.5%) at a mean of 10.9±5.1 months after diagnosis. PED development was noted within 12 months in 15 patients (46.8%; 75.0% among the PED development cases). In 52 patients with serous PED and without SRF at diagnosis, 15 developed SRF (28.8%) at a mean of 11.2±6.4 months after diagnosis. SRF development was noted within 12 months in 9 patients (17.3%; 66.6% among the SRF development cases).

Conclusions:
PED and SRF developed in a substantial proportion of patients with type 3 MNV. The average period of development of these pathologic findings was within 12 months of diagnosis, suggesting the need for active treatment during the early treatment period to improve treatment outcomes.
SCLEROCHOROIDAL CALCIFICATION WITH OPTIC NERVE CALCIFICATION IN A PATIENT WITH PRIMARY HYPERPARATHYROIDISM AND SEVERE VISION LOSS
Authors: Sood Shefali , Friedman Scott 
Published: March 2023

Background/Purpose:
To present a case of sclerochoroidal calcification (SCC) associated with dural calcification along the optic nerves and severe visual loss.

Methods:
Case report.

Results:
A 74-year-old white female patient with a 25-year history of primary hyperparathyroidism and surgical removal of a single parathyroid gland presented with blurred vision. On presentation, she had a calcium level of 12.6 mg/dL (reference range: 8.7–10.3 mg/dL). Her best-corrected visual acuity (BCVA) was 20/40 in both eyes, and she was diagnosed with bilateral SCC. After 2 years, the patient returned with a complaint of progressive vision loss, and the BCVA was 20/150 in the right eye and hand motion in the left eye. She had stable focal SCC on fundus examination with no significant changes from the previous examination. The fluorescein angiogram was unremarkable with no leakage. Optical coherence tomography (OCT) of the macula showed no edema or subretinal fluid and was not significantly changed from the first OCT. B-scan showed areas of calcification in the sclera consistent with the SCC. Computerized tomography (CT) scans showed dural calcifications along both optic nerves. She had no enlargement of SCC lesions and no other ocular or neurologic pathology associated with her vision loss.

Conclusion:
We present a patient with bilateral SCC and associated calcification in both globes. Unlike previous reports of SCC, our case demonstrated progressive severe vision loss because of dural calcification along the optic nerves. Patients with SCC and decreased vision should receive a CT scan to look for this rare associated finding.
INTRAVITREAL METHOTREXATE IN VEMURAFENIB-INDUCED UVEITIS
Authors: Dugauquier Artémise , Awada Ahmad Hussein , Motulsky Elie , Kisma Nacima 
Published: March 2023

Purpose:
Vemurafenib, a BRAF inhibitor, has revolutionized the prognosis of late-stage melanoma patients, rising at the same time concerns about its potential adverse effects. Here is a case of vemurafenib-induced uveitis, peculiar in both its presentation and management.

Methods:
Case report, diagnostic, and therapeutic challenge.

Results:
Uveitis is a known side effect of vemurafenib. It is generally bilateral, moderate, manageable with topical steroids, and does not require cancer therapy cessation. We present a patient who suffered from a unilateral, severe uveitis after vemurafenib treatment that fully recovered thanks to intravitreal methotrexate injections because conventional corticosteroid therapy was contraindicated.

Conclusion:
Uveitis can be a serious ocular adverse effect of vemurafenib, whereas its risk factors and mechanisms remain unknown. As BRAF inhibitors are now used on a regular basis, it is important for clinicians to be aware of this potentially sight-threatening side effect. Intravitreal methotrexate injections may be considered as an effective treatment choice in severe targeted agents-induced uveitis.
THE LONG-TERM OUTCOME OF EYES WITH UNEXPLAINED VISUAL LOSS AFTER GAS TAMPONADE FOR MACULA-ON RETINAL DETACHMENT
Authors: Iuliano Lorenzo , Corbelli Eleonora , Bandello Francesco , Codenotti Marco 
Published: March 2023

Purpose:
To analyze the long-term outcome of eyes suffering from unexplained visual loss after gas tamponade for primary macula-sparing rhegmatogenous retinal detachment.

Methods:
Cross-sectional analysis of all eyes with macula-on rhegmatogenous retinal detachment experiencing an unexplained loss of vision after gas reabsorption that were treated and followed from 2010 to 2019. The investigational work-up included: best-corrected visual acuity (BCVA), clinical examination, spectral-domain optical coherence tomography, and automated computerized perimetry.

Results:
The nine eyes of the nine patients were analyzed after 5.9 ± 2.4 years. Best-corrected visual acuity improved by 0.54 ± 0.50 logMAR from baseline, achieving a final value of 1.17 ± 0.52 logMAR (∼20/320; P = 0.0115). The thicknesses of the macula, of the macular ganglion cells, and of the retinal nerve fiber layers were unchanged compared with the baseline, and the rate of ellipsoid zone defects (22.2%). The proportion of eyes with microcystoid macular edema significantly decreased to 44.4% (P = 0.0294). Perimetry mean deviation increased from a baseline value of −18.06 ± 2.72 to −17.23 ± 2.29 dB (P = 0.0390), with an unchanged pattern SD (P = 0.1289). In general, a reduction of the scotomata relative depth from baseline was evident in all eyes.

Conclusion:
Eyes with macula-on rhegmatogenous retinal detachment suffering from unexplained visual loss after gas reabsorption, despite disclosing an overall unchanged structural macular morphology, showed a moderate, but significant, visual and perimetric improvement in the long-term.
A CASE OF HERPES SIMPLEX VIRUS AND CYTOMEGALOVIRUS RETINITIS COINFECTION
Authors: Lopez Jennifer , Hua Hong-Uyen , Toy Brian C. 
Published: March 2023

Purpose:
The purpose of this study was to describe a case of a 64-year-old man presenting with cytomegalovirus and herpes simplex virus retinitis coinfection in the setting of Burkitt lymphoma.

Methods:
A case report including multimodal imaging and anterior chamber polymerase chain reaction results was used.

Results:
This case highlights the importance of the clinical examination and maintaining high diagnostic suspicion for viral retinitis in immunocompromised patients.

Conclusion:
Aqueous fluid PCR can be a useful adjunctive test to distinguish and confirm a diagnosis of viral retinitis. Given the limited sample volume of aqueous biopsy, it is important to prioritize the order of PCR testing based on clinical suspicion of the causative agent.