bluuebunny/crossref_metadata_2025_split huggingface dataset:
Practice Standards for the Use of Multimodality Neuromonitoring: A Delphi Consensus Process*
Authors: Foreman Brandon , Kapinos Gregory , Wainwright Mark S. , Ngwenya Laura B. , O’Phelan Kristine H. , LaRovere Kerri L. , Kirschen Matthew P. , Appavu Brian , Lazaridis Christos , Alkhachroum Ayham , Maciel Carolina B. , Amorim Edilberto , Chang Jason J. , Gilmore Emily J. , Rosenthal Eric S. , Park Soojin 
Published: August 2023

OBJECTIVES:
To address areas in which there is no consensus for the technologies, effort, and training necessary to integrate and interpret information from multimodality neuromonitoring (MNM).

DESIGN:
A three-round Delphi consensus process.

SETTING:
Electronic surveys and virtual meeting.

SUBJECTS:
Participants with broad MNM expertise from adult and pediatric intensive care backgrounds.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Two rounds of surveys were completed followed by a virtual meeting to resolve areas without consensus and a final survey to conclude the Delphi process. With 35 participants consensus was achieved on 49% statements concerning MNM. Neurologic impairment and the potential for MNM to guide management were important clinical considerations. Experts reached consensus for the use of MNM—both invasive and noninvasive—for patients in coma with traumatic brain injury, aneurysmal subarachnoid hemorrhage, and intracranial hemorrhage. There was consensus that effort to integrate and interpret MNM requires time independent of daily clinical duties, along with specific skills and expertise. Consensus was reached that training and educational platforms are necessary to develop this expertise and to provide clinical correlation.

CONCLUSIONS:
We provide expert consensus in the clinical considerations, minimum necessary technologies, implementation, and training/education to provide practice standards for the use of MNM to individualize clinical care.
Clinical characteristics of pediatric hypertension: a multicenter study in China
Authors: Chen Yijun , Ye Peiyu , Dong Hongbo , Xu Xin , Shi Lin , Li Bin , Dong Jie , Lv Aiting , Su Zhe , Zhang Yong , Zhou Yunguo , Wang Juanli , Feng Guoshuang , Zeng Yueping , Ni Xin , Mi Jie 
Published: August 2023

Objectives:
Hypertension in children has attracted increasing attention. However, clinical-based studies investigating characteristics and secular trends of pediatric hypertension remain limited. This study aimed to investigate the clinical characteristics and secular trends of different types of hypertension among hospitalized children in China.

Methods:
This retrospective analysis was based on medical records from nine tertiary children's hospitals in China during 2010∼2020. A total of 5847 pediatric inpatients (aged <18 years) with the diagnosis of hypertension were enrolled. Information on the clinical characteristics of each patient was obtained from their first admission records.

Results:
During the past decade, secondary hypertension sustained to be the dominant type of hypertension in children, with the proportion increased from 51.2% during 2010∼2015 to 59.8% during 2016∼2020. The main causes of secondary hypertension were neurologic disorders in children aged 0∼2 years, which changed to renal diseases after 3 years of age. Compared with primary hypertension, secondary hypertension was common in girls (43.1 vs. 23.3%) and children under 5 years of age (32.2 vs. 2.1%). Moreover, over four-fifths of primary hypertensive individuals had obesity and obesity-related comorbidities, and the proportion of clusters of one or more comorbidities increased in the past decade (79.7 → 85.2%).

Conclusion:
Secondary hypertension sustained to be the dominant type of hypertension among children, especially in girls. Renal diseases were the most common causes of secondary hypertension in children, followed by rheumatic immune diseases. For primary hypertension, over four-fifths of inpatients had obesity and obesity-related diseases, and the proportion kept rising.
A set of urinary peptides can predict early renal damage in primary hypertension
Authors: Lin Lirong , Ren Jiangwen , Wang Chunxuan , Mei Mei , Zheng Luquan , Yang Jurong 
Published: August 2023

Objectives:
Renal diseases caused by primary hypertension (HTN) are often asymptomatic without sensitive markers for early diagnosis and prediction, easily progressing to severe and irreversible renal damage in patients with clinical manifestations. This study explored whether a set of urinary peptides could serve as a potential biomarker for early prediction of renal damage in HTN.

Methods:
Urinary peptides level of healthy individuals, HTN + normoalbuminuric and HTN + albuminuria patients were compared, and 22 baseline data including sex, age, renal function, hypertensive fundus lesions were collected. Patients diagnosed with HTN, albuminuria, and normal renal function were followed up. According to the follow-up results, the cut-off value of a set of urinary peptides in predicting hypertensive renal injury was calculated and analyzed in the high-risk and low-risk groups of HTN patients for its performance in detecting early hypertensive renal injury.

Results:
Among a sum of 319 participants, average urinary peptides level was significantly higher in patients with HTN than in normal individuals. A total of 147 HTN patients with normal albuminuria were followed up for a mean of 3.8 years. Thirty-five patients showed urinary albumin-to-creatinine ratio (uACR) at least 30 mg/g for three consecutive times. The receiver-operating characteristic (ROC) curve showed that the urinary peptides cut-off value for evaluating new-onset proteinuria in patients with HTN was 0.097. Based on this cut-off value, 39 and 108 patients were included in the high-risk and low-risk groups, respectively. Specifically, compared with patients in the low-risk group, those in the high-risk group showed significantly longer duration of HTN, higher proportions of hypertensive fundus lesions and at least 30 mg/g uACR, and higher levels of homocysteine (Hcy), cystatin C (CysC), beta-2 microglobulin (β2-MG), and uACR. 76.9% of high-risk patients had significantly higher new-onset proteinuria than the low-risk group. Correlation analysis demonstrated a positive correlation between urinary peptides and UACR (r = 0.494, P < 0.001). The incidence of new-onset albuminuria was significantly higher in the high-risk group than in the low-risk group, as shown by Cox regression analysis. The areas under the curve of urinary peptides, Hcy, β2-MG and CysC were 0.925, 0.753, 0.796 and 0.769, respectively.

Conclusion:
A set of urinary peptides is a predictor of new-onset proteinuria in patients with HTN, therefore, it can be used for diagnosing patients with early renal injury in patients with HTN, contributing to early prevention and treatment of hypertensive nephropathy.
Characteristics of Participants in Diabetic Retinopathy Clinical Research Clinical Trials Who Were Lost to Follow up
Authors: Bowe Theodore , Mahmoudzadeh Raziyeh , Soares Rebecca R. , Nguyen Michael K. , Hsu Jason , Kuriyan Ajay E. 
Published: August 2023

Abstract

Purpose:
Our study describes the racial/ethnic composition and the broad health status/severity of disease of the cohorts of Diabetic Retinopathy Clinical Research (DRCR) clinical trials and compares the rates of non-completion of the trial to the first data report (lost to follow up (LTFU)).

Methods:
This study is a retrospective cohort study of participants in Diabetic Retinopathy Clinical Research (DRCR) Retina Network clinical trials that met our inclusion criteria.
The primary outcome was the lost to follow up rates and their associated risk factors.

Results:
Eight clinical trials with 3492 participants met our inclusion criteria. Participants who were LTFU were more likely younger, Hispanic or Black, Type 1 DM, worse baseline BCVA, higher HbA1c, higher BP, and had PDR (Diabetic Retinopathy Severity Score >66).

Conclusions:
Participants who were LTFU during DRCR clinical trials tended to be younger, Hispanic or Black, and have worse diabetes and hypertension. This study highlights the importance of ensuring a representative population is maintained through the end of the study period.
CHLOROQUINE-INDUCED MACULAR TOXICITY IN A PATIENT LATER DEVELOPING SECTOR RETINITIS PIGMENTOSA: A CASE REPORT
Authors: Cañas-Martín Julia , Bolívar de Miguel Gema , Teus Guezala Miguel A. , Arruabarrena Sánchez Carolina 
Published: August 2023

Purpose:
To describe how underlying retinal diseases, such as retinitis pigmentosa, increase the risk of chloroquine (CQ)-induced macular toxicity.

Methods:
A observational case report.

Results:
We present the case of a 57-year-old woman being annually followed up in the ophthalmology service because of a systemic treatment with CQ. The explorations were successive normal, until a 10:2 visual field shows central defects in both eyes. Despite CQ treatment is discontinued, 10:2 visual field reveals slowly progressive macular defects. During follow-up, fundus examination disclosed bone spicules in the inferonasal middle periphery: The electroretinogram shows slow amplitude responses under scotopic conditions, and the electrooculogram also shows pathological responses. Therefore, the diagnosis of sector retinitis pigmentosa plus CQ maculopathy is made. Currently, the slow but constant progression of both peripheral and central defects is evident, despite having discontinued CQ treatment more than 15 years ago.

Conclusion:
Underlying retinal diseases seem to increase the risk of photoreceptor damage when undergoing a toxic insult. Thus, we hypothesize a potential interplay between retinal dystrophies and toxic maculopathy induced by CQ and the influence of each of them in the evolution and prognosis of the other.
Quintuple Procedure for Ocular Surface Reconstruction and Visual Rehabilitation
Authors: Navia Juan Carlos , Carletti Piero , Camacho Matthew , Dubovy Sander R. , Martinez Jaime D. 
Published: August 2023

Purpose:
The aim of this study was to describe a combined surgical approach for ocular surface and visual rehabilitation in patients with limbal stem cell deficiency, corneal scarring, and cataract. We aimed to introduce this combined approach as an alternative to a staged approach and to describe the intraoperative use of a diamond ophthalmic burr (DOB) and optical coherence tomography (OCT) to achieve and confirm a smooth graft–host interface during the anterior lamellar keratoplasty (ALK) portion of the procedure.

Methods:
The quintuple procedure described herein consists of a modified ALK, cataract extraction, intraocular lens implantation, simple limbal epithelial transplantation, and temporal tarsorrhaphy. Intraoperative OCT and DOB were used to guide the creation of the stromal bed during the ALK. The procedure was performed in a patient with limbal stem cell deficiency and corneal scarring after a chemical ocular burn.

Results:
The tarsorrhaphy was removed at 3 months postoperatively once complete corneal epithelialization was observed. The best-corrected visual acuity improved from light perception preoperatively to 20/30 at 16 months postoperatively with the use of scleral contact lenses. At this postoperative time point, the cornea was clear and compact, and the ocular surface was stable.

Conclusions:
The quintuple procedure allowed for visual and ocular surface rehabilitation in cases in which follow-up for a staged approach was not possible. Intraoperative OCT allowed for real-time visualization and dissection of the stromal bed, whereas the use of the DOB helped achieve a smooth stromal surface for an optimal graft–host interface.
Comparative Analysis of Alternative Calcium Chelators for the Treatment of Calcific Band Keratopathy
Authors: Guo Zhuojun , Henry Roger K. , Dastjerdi Mohammad H. 
Published: August 2023

Purpose:
In this study, we compared clinically relevant biochemical properties of each chelator for pH, osmolarity, and calcium chelation potential.

Methods:
In total, 0.2 M K2EDTA and K3EDTA (BD vacutainer tubes by Becton, Dickinson and Company) and Na2EDTA (Sigma Aldrich) solutions were made. The pH of each solution was measured (Mettler Toledo pH meter), and the theoretical osmolarity was calculated. Next, we determined the calcium chelation potential of each EDTA salt by titrating it with 10 μmol of calcium hydroxyapatite or CaCl2 containing Patton–Reeder colorimetric indicator. Statistical significance was analyzed using analysis of variance.

Results:
The 0.2 M solutions of Na2EDTA, K2EDTA, and K3EDTA have pH values of 4.43, 5.71, and 9.191 and theoretical osmolarities of 600, 600, and 800 mOsm/L, respectively. Calcium chelation ability was similar among all 3 solutions: 0.94 to 0.98 mol of EDTA was needed to fully chelate 1 mol calcium ions of CaCl2 (P = 0.296), 0.100 to 0.108 mol of EDTA for 1 mol calcium ions of the hydroxyapatite aqueous suspension (P = 0.296), and 0.992 to 0.996 mol for 1 mol calcium ions of hydroxyapatite in acidic solution (P = 0.178). Compared with the clinical standard of 3% (30 mg/mL) Na2EDTA, approximately 3.3% (33 mg/mL) K2EDTA and 3.6% (36 mg/mL) K3EDTA are needed to chelate an equivalent amount of calcium.

Conclusions:
In this article, we provide clinically relevant biochemical properties of 2 alternatives to Na2EDTA and demonstrate comparable calcium chelation ability among all 3 solutions. In situations where sterile sources of Na2EDTA are unavailable, potassium EDTA may provide a convenient and equally effective method of treatment for band keratopathy.
The impact of full practice authority on nurse practitioner compensation, collaboration, and billing
Authors: Tracy Christine , Russell Nancy G. , DePriest Kelli , Knestrick Joyce , D'Aoust Rita , Slade Eric 
Published: August 2023

ABSTRACT

Background:
Although there is a substantial body of evidence regarding full practice authority's (FPA) effects on health care access and quality, very little research has examined how nurse practitioner (NP) licensure laws affect the status of NPs as clinicians, employees, and leaders in health care organizations.

Purpose:
This study examined whether states’ implementation of FPA leads to higher pay, business ownership, assigned patient panel, and billing transparency for NPs' and whether NPs' gains from FPA increase over time in states where FPA has been in effect longer.

Methodology:
Data from a nationwide survey of licensed NPs (N = 5,770) were used to compare NPs' employment conditions between FPA and non-FPA states. After balancing the FPA and non-FPA groups on demographic characteristics (e.g., urbanicity, education), adjusted mean differences in outcomes between the groups were estimated using weighted multivariable regression.

Results:
Compared with NPs in non-FPA states, NPs in FPA states had higher mean earnings (p < .05), were more likely to be practice owners or shareholders (p < .01), and billed a greater percentage of their patient visits under their own National Provider Identifier (p < .001). Having FPA in place for ≥10 years was associated with greater improvements in conditions of employment compared with having FPA <10 years.

Conclusions:
States' adoption of FPA for NPs is associated with improved conditions of employment among NPs.

Implications:
Untethering NPs from physicians establishes a cascade of modest gains in income and practice ownership that may indicate changes over time. Additional research is needed to determine the trajectory of these increases and if they are consistent.
Efficacy and safety of acupoint application in the treatment of ulcerative colitis: A systematic review and meta-analysis
Authors: Tong Yaling , Yu Yunfeng , Yin Shuang , Lin Shanzhi , Chen Yun , Su Xuan 
Published: August 2023

Background:
The efficacy of acupoint application in the treatment of ulcerative colitis (UC) is still controversial. The purpose of this study is to systematically evaluate the clinical efficacy and safety of acupoint application in the treatment of ulcerative colitis.

Methods:
The databases of China National Knowledge Infrastructure (CNKI), Chinese Biology Medicine (CBM), VIP, Wanfang, Embase, PubMed, the Cochrane Library and Web of Science were searched. The time limit was from the establishment of the database to July 2022. The published randomized controlled trials of acupoint application in the treatment of UC were analyzed by meta-analysis and trial sequential analysis.

Results:
A total of 13 studies were included, with a total sample size of 878 cases. Compared with conventional western medicine, acupoint application can effectively improve the effective rates of clinical comprehensive (risk ratio [RR] 1.13, 95% confidence interval [CI] 1.06–1.20, P = .0003), syndrome (RR 1.13, 95% CI 1.03–1.24, P = .009), and interleukin-4 (IL-4) (mean differences 2.62, 95% CI 1.96–3.28, P < .00001) in the treatment of UC, and reduce interferon-γ (mean differences −5.38, 95% CI −6.81 to −3.94, P < .00001). The effective rates of colonoscopy (RR 0.94, 95% CI 0.84–1.05, P = .25), pathological examination (RR 1.04, 95% CI 0.90–1.20, P = .60) and rate of adverse reaction (RR 0.55, 95% CI 0.25–1.21, P = .14) were the same. Trial sequential analysis indicated that the benefits of effective rates of clinical comprehensive and syndrome, IL-4, and interferon-γ were conclusive. Harbord regression showed no publication bias (P = .98). The evaluation of evidence quality suggested that the evidence quality of effective rates of clinical comprehensive and syndrome was moderate and the evidence quality of other indicators was low or very low.

Conclusion:
Acupoint application is a safe and effective method for the treatment of UC, and has the prospect of clinical application.
Effect of different analgesic treatments on the pulmonary function in elderly hip fracture patients: A prospective study
Authors: Wang Shunhong , Xu Yueming , Kang Yongjian , Qin Zhigang , Peng Chunyu , Lin Hong 
Published: August 2023

Background:
To investigate the effect of different analgesic methods on lungs in elderly patients with hip fractures.

Methods:
A prospective study was conducted on 78 elderly hip fracture patients undergoing spinal anesthesia for surgery, where 3 analgesic methods were used: postoperative Patient-controlled intravenous analgesia pump (PCIA) (group I), pre and postoperative PCIA (group II), and preoperative fascia iliaca compartment block (FICB) + postoperative PCIA (group III). The following indicators were monitored at admission (T1), on the day of surgery before anesthesia (T2), and 7 days after surgery (T3): heart rate (HR), respiratory rate (RR), forced expiratory volume during the first second, arterial partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2), C-reactive protein (CRP), and interleukin 6 (IL-6). Pulmonary complications such as pulmonary atelectasis and respiratory insufficiency were analyzed.

Results:
The HR, RR, forced expiratory volume during the first second, PaO2, PaCO2, IL-6, and CRP levels at T1 after fracture did not significantly differ among the 3 groups (P > .05). After different analgesic treatments post-admission, all indicators at T2 were significantly higher in group I than in groups II and III (P < .05), while there was no significant difference between groups II and III (P > .05). At T3, there were no significant differences in RR, HR, PaO2, PaCO2, and CRP levels among the groups (P > .05), but IL-6 levels at T3 were significantly higher in group I than in groups II and III (P < .05).

Conclusion:
The use of effective pain relief during surgery can help protect the lung function of elderly patients with hip fractures. When using PCIA with FICB before surgery, respiratory performance may be better protected compared to using unsustained analgesia. This could be due to a decrease in the levels of inflammatory markers such as CRP and interleukin-6.
Astragaloside IV relieves IL-1β-induced human nucleus pulposus cells degeneration through modulating PI3K/Akt signaling pathway
Authors: Zhang Lu , Gao Junsheng , Li Zhentao , Liu Jun , Zhang Chong , Liu Jie , Dong Hui , Mei Wei 
Published: August 2023

Background:
Intervertebral disc degeneration (IDD) is a multifactorial disease that is associated with nucleus pulposus (NP) apoptosis and extracellular matrix (ECM) degeneration and inflammation. Astragaloside IV (AS IV) has antioxidant, free radical scavenging, anti-inflammatory and anti-apoptosis effects. This study was to investigate whether AS IV could inhibit IL-1β-mediated apoptosis of HNP cells and its possible signal transduction pathway.

Methods:
Human nucleus pulposus cells (HNPCs) were stimulated with AS IV or LY294002 (PI3K inhibitor), followed by exposure to IL-1β for 24 hours. CCK8, TUNEL analysis and flow cytometry, ELISA and Western blotting were used to analyze the effects of AS IV on cell proliferation, apoptosis, inflammation, ECM and PI3K/Akt pathway signaling path-related proteins in IL-1β-induced HNPCs.

Results:

Compared with IL-1β-induced HNPCs, AS IV could improve the proliferation activity and the expressions of Collagen II, Aggrecan and Bcl-2 proteins, inhibit the apoptosis rate, inflammation and Bax and cleaved caspase-3 protein expression, and increase the activity of PI3K/Akt pathway. LY294002 attenuated the protective effect of AS IV against IL-1β-induced HNPCs degeneration.

Conclusion:
AS IV can inhibit IL-1β-induced HNPCs apoptosis inflammation and ECM degeneration by activating PI3K/Akt signaling pathway, which can be an effective drug to reduce disc degeneration.
The immunology of PF4 polyanion interactions
Authors: Ngo Anh T.P. , Bochenek Veronica , Gollomp Kandace 
Published: August 2023

Purpose of review
Platelet factor 4 (PF4, CXCL4), the most abundant α-granule platelet-specific chemokine, forms tetramers with an equatorial ring of high positive charge that bind to a wide range of polyanions, after which it changes conformation to expose antigenic epitopes. Antibodies directed against PF4 not only help to clear infection but can also lead to the development of thrombotic disorders such as heparin-induced thrombocytopenia (HIT) and vaccine-induced thrombocytopenia and thrombosis (VITT). This review will outline the different mechanisms through which PF4 engagement with polyanions combats infection but also contributes to the pathogenesis of inflammatory and thrombotic disease states.

Recent findings
Recent work has shown that PF4 binding to microbial polyanions may improve outcomes in infection by enhancing leukocyte-bacterial binding, tethering pathogens to neutrophil extracellular traps (NETs), decreasing the thrombotic potential of NET DNA, and modulating viral infectivity. However, PF4 binding to nucleic acids may enhance their recognition by innate immune receptors, leading to autoinflammation. Lastly, while HIT is induced by platelet activating antibodies that bind to PF4/polyanion complexes, VITT, which occurs in a small subset of patients treated with COVID-19 adenovirus vector vaccines, is characterized by prothrombotic antibodies that bind to PF4 alone.

Summary
Investigating the complex interplay of PF4 and polyanions may provide insights relevant to the treatment of infectious disease while also improving our understanding of the pathogenesis of thrombotic disorders driven by anti-PF4/polyanion and anti-PF4 antibodies.