bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Clusters of Double Triggering and Ineffective Efforts in Critically Ill Patients
Authors: Magrans Rudys , Ferreira Francini , Sarlabous Leonardo , López-Aguilar Josefina , Gomà Gemma , Fernandez-Gonzalo Sol , Navarra-Ventura Guillem , Fernández Rafael , Montanyà Jaume , Kacmarek Robert , Rué Montserrat , Forné Carles , Blanch Lluís , de Haro Candelaria , Aquino-Esperanza José ,   For the ASYNICU group
Published: February 2022

OBJECTIVES:
To characterize clusters of double triggering and ineffective inspiratory efforts throughout mechanical ventilation and investigate their associations with mortality and duration of ICU stay and mechanical ventilation.

DESIGN:
Registry-based, real-world study.

Background:
Asynchronies during invasive mechanical ventilation can occur as isolated events or in clusters and might be related to clinical outcomes.

Subjects:
Adults requiring mechanical ventilation greater than 24 hours for whom greater than or equal to 70% of ventilator waveforms were available.

INTERVENTIONS:
We identified clusters of double triggering and ineffective inspiratory efforts and determined their power and duration. We used Fine-Gray’s competing risk model to analyze their effects on mortality and generalized linear models to analyze their effects on duration of mechanical ventilation and ICU stay.

MEASUREMENTS AND MAIN RESULTS:
We analyzed 58,625,796 breaths from 180 patients. All patients had clusters (mean/d, 8.2 [5.4–10.6]; mean power, 54.5 [29.6–111.4]; mean duration, 20.3 min [12.2–34.9 min]). Clusters were less frequent during the first 48 hours (5.5 [2.5–10] vs 7.6 [4.4–9.9] in the remaining period [p = 0.027]). Total number of clusters/d was positively associated with the probability of being discharged alive considering the total period of mechanical ventilation (p = 0.001). Power and duration were similar in the two periods. Power was associated with the probability of being discharged dead (p = 0.03), longer mechanical ventilation (p < 0.001), and longer ICU stay (p = 0.035); cluster duration was associated with longer ICU stay (p = 0.027).

CONCLUSIONS:
Clusters of double triggering and ineffective inspiratory efforts are common. Although higher numbers of clusters might indicate better chances of survival, clusters with greater power and duration indicate a risk of worse clinical outcomes.
Advances in new antivirals for chronic hepatitis B
Authors: Tang Yanhua , Liang Hongyan , Zeng Ge , Shen Sheng , Sun Jian 
Published: February 2022

Abstract
Chronic hepatitis B virus (HBV) infection remains a global health burden. Timely and effective antiviral therapy is beneficial for patients with HBV infection. With existing antiviral drugs, including nucleos(t)ide analogs and interferon-alfa, patients can achieve viral suppression with improved prognosis. However, the rate of hepatitis B surface antigen loss is low. To achieve a functional cure and even complete cure in chronic hepatitis B patients, new antivirals need to be developed. In this review, we summarized the advantages and disadvantages of existing antiviral drugs and focused on new antivirals including direct-acting antiviral drugs and immunotherapeutic approaches.
Corneal Endothelial Dysfunction as a Manifestation of Digoxin Toxicity
Authors: Mendoza-Moreira Angi Lizbeth , Rodrigo-Rey Sara , Figuerola-García María Belén , González-Alonso Ángela , Marcos-Parra María Teresa , Pérez-Santonja Juan J. 
Published: February 2022

Purpose:
The purpose of this study was to report a case of corneal endothelial dysfunction and subsequent corneal edema in a patient with digoxin toxicity.

Method:
This was a case report.

Results:
A 77-year-old woman diagnosed with open-angle glaucoma and treated with a topical prostaglandin analog for 5 years developed blurred vision and photopsia in both eyes. Systemic medications included digoxin, furosemide, apixaban, amlodipine, enalapril, and simvastatin. Ocular examination revealed folds in Descemet membrane and corneal stromal edema in both eyes, with normal fundoscopy. Ancillary tests revealed elevated serum digoxin levels. No intervention other than discontinuation of digoxin was initiated. The corneal edema improved after that and resolved in the next 2 weeks.

Conclusions:
We encountered 1 case of corneal edema secondary to corneal endothelial dysfunction in a patient with digoxin toxicity. Special care should be taken to elicit a complete history because ocular signs can be manifestations of systemic alterations with vital importance for patients.
Posterior Chamber Intraocular Lens Dislocation Into the Vitreous in Association With Descemet Stripping Lamellar Keratoplasty
Authors: Rodler Kristóf Dániel , Pregun Tamás , András Bernadett , Pluzsik Milán Tamás , Hargitai János , Kerényi Ágnes 
Published: February 2022

Purpose:
The purpose of this study was to report 3 cases of a single-piece, acrylic, foldable, modified C loop posterior chamber intraocular lens (PCIOL) dislocated into the vitreous cavity after Descemet stripping automated endothelial keratoplasty (DSAEK).

Method:
We describe the clinical course and management of the 3 cases in which a previously implanted foldable, single-piece, acrylic posterior chamber intraocular lens with modified C loops dislocated into the vitreous in association with DSAEK. Surgical management consisted of pars plana vitrectomy in each case with either PCIOL repositioning (2 cases) or PCIOL exchange (1 case) and with different fixation methods, combined with repeated DSAEK in 1 case with previous primary graft failure.

Results:
In 2 cases where the cornea cleared after the DSAEK, the cornea kept its clarity and the PCIOL remained stable. In the third case in which the PCIOL exchange was combined with DSAEK, the cornea only partially cleared up, both the PCIOL and the state of the eye remained stable.

Conclusions:
PCIOL dislocation is a possible and notable complication that requires attention while performing DSAEK on pseudophakic eyes. Not only plate-haptic silicone but also acrylic, single-piece PCIOLs with modified C loops may dislocate into the vitreous in association with DSAEK in cases with compromised capsular or zonular integrity.
Diurnal Variation in Straylight in Patients With Fuchs Endothelial Corneal Dystrophy and Controls
Authors: de Jong Bram , Brandi-Dohrn Franziska , van der Meulen Ivanka J. E. , van den Berg Thomas J. T. P. , Wacker Katrin 
Published: February 2022

Purpose:
The goal of this study was to investigate diurnal changes in intraocular straylight in relation to other corneal parameters and subjective complaints in patients with Fuchs endothelial dystrophy and healthy controls.

Methods:
This is a prospective study conducted in 2 tertiary care hospitals in Germany and the Netherlands. Patients with Fuchs endothelial dystrophy (n = 71) and healthy controls (n = 34) were included. Patients with Fuchs dystrophy were grouped by the presence of subjective complaints and measured over multiple time points during the day. Measurements included intraocular straylight using the C-Quant and corneal thickness and backscatter using a Scheimpflug camera. A separate group of healthy controls was measured intensively with repeated straylight measurements directly after waking. An exponential decay model was used to model the diurnal change.

Results:
Healthy controls showed an average straylight baseline of 1.17 log(s) with an increase in straylight after waking of 0.22 log(s). In the repeated measurements subgroup, the increase in morning straylight lasted for 22 minutes. Patients with Fuchs dystrophy showed a morning increase in straylight of 0.21 log(s) present up to 4 hours after waking before reaching an average baseline of 1.30 log(s). Straylight was positively correlated with anterior corneal backscatter, r = 0.21, P = 0.022, and corneal thickness, r = 0.46, P < 0.01.

Conclusions:
Healthy eyes experience a diurnal straylight increase similar to patients with Fuchs dystrophy in intensity. However, in Fuchs dystrophy, the resolution of increased straylight is prolonged over multiple hours compared with minutes in healthy eyes. This suggests pathological exacerbation of a physiological diurnal change. This mechanism can play a role in subjective complaints experienced by patients with Fuchs dystrophy.
p62/SQSTM1 Participates in the Innate Immune Response of Macrophages Against Candida albicans Infection
Authors: He Yan-Zhi , Duan Zhi-Min , Chen Xu , Li Min 
Published: February 2022

Abstract

Objective:
This study was designed to evaluate whether p62/SQSTM1 (hereafter referred to as p62) is involved in the immune response of macrophages against challenge by Candida albicans (C. albicans).

Methods:
We cultured bone marrow-derived macrophages (BMDMs) to investigate the immune response to challenge by C. albicans. The p62 gene was knocked down by transfection with p62 small interfering RNA (siRNA) in the p62 siRNA group. BMDMs transfected with nonsense siRNA served as the negative control (NC) group. These two groups of BMDMs were challenged with C. albicans in vitro. We detected p62 expression through quantitative reverse transcription PCR and western blotting. The phagocytosis ability of BMDMs was evaluated by flow cytometry and microscopic examination using an Olympus FV1000 laser scanning confocal microscope. Moreover, we determined the level of reactive oxygen species (ROS) in BMDMs. The mRNA levels of proinflammatory cytokines were determined by quantitative reverse transcription PCR.

Results:
After stimulation by C. albicans, the relative expression of p62 mRNA was increased in a dose-dependent manner, the relative expression of p62 and the ratio of BMDMs to C. albicans is 1.893 ± 0.2156 (1:1, P < 0.05), 2.873 ± 0.4787 (1:3, P < 0.05) and 3.556 ± 0.2892 (1:5, P < 0.01). The p62 protein level was also increased. After transfection with p62 siRNA, the mRNA and protein levels of p62 were significantly decreased in BMDMs (P < 0.05). After 0.5, 1 and 2 hours of co-culture of BMDMs with C. albicans, flow cytometry showed that the phagocytosis rates of C. albicans by BMDMs were significantly lower in the p62 siRNA group than in the NC group (39.70 ± 1.69% vs. 55.23 ± 0.72%, 46.70 ± 0.89% vs. 60.80 ± 1.78%, 51.90 ± 0.98% vs. 64.43 ± 2.0%, respectively, all P < 0.05). Consistent results were seen in the production of ROS (4269 ± 392.6 vs. 13426 ± 1859.7, 4967 ± 721.2 vs. 13687 ± 2611.2, 7647 ± 1950.0 vs. 17719 ± 1814.2, respectively, all P < 0.05). The ROS levels were higher in BMDMs of the NC group than in BMDMs transfected with p62 siRNA at 0.5, 1, and 2 hours after treatment with C. albicans. BMDMs was co-cultured with C. albicans for 4 and 12 hours, the mRNA levels of interleukin-1β and interleukin-18 in NCs were also higher than p62 siRNA group, interleukin-1β: (6.14 ± 1.63 vs. 12.12 ± 0.54, 8.81 ± 0.86 vs. 26.2 ± 4.67, respectively, all P < 0.05), IL-18: (0.38 ± 0.02 vs. 0.97 ± 0.06, 0.44 ± 0.02 vs. 2.23 ± 0.46, respectively, all P < 0.05).

Conclusion:
p62 plays an important role in the process of phagocytosis in BMDMs challenged by C. albicans through ROS production and expression of proinflammatory cytokines.
Impact of Pre-admission Observation Hours on Key Physical Therapist Clinical Education Stakeholders: Qualitative Analysis
Authors: Hoang Thuha , Watkins Molly , Bayliss Jamie , Schack-Dugre Judi , Mitchell Katy , Mariano Mira , Greco Jamie , Colgrove Yvonne , Wheeler Emma , Kiyota Hiroshi , Pientok Colette , Stephens Laura , McCarthy Casey , Canham Lara , McBride Gavin , Gleeson Peggy 
Published: February 2022

Introduction.
Inclusion of preadmission observation hours (ObHr) as one component of the admissions process is commonly required in physical therapy education programs. The purpose of this study was to describe the value and impact of ObHr on 4 key stakeholder groups: doctor of physical therapy students, physical therapy clinicians, directors of clinical education, and admissions committee (AC) members.

Review of Literature.
The number of required and/or recommended ObHr and practice settings varies greatly. No previous study has explored a national dataset of key stakeholders' perspectives on ObHr experiences.

Subjects.
Four key stakeholder groups were targeted in the study (N = 4,471).

Methods.
Four stakeholder surveys were developed and distributed via email using a snowball sampling technique. Responses to the open-ended questions were analyzed using conventional content analysis for creating codes, categories, and themes within and across groups.

Results.
Five main themes emerged: 1) ObHr have value in career decision making; 2) students driven by hours, but all stakeholders value variety; 3) use of ObHr for program admissions decisions varies; 4) as the number of hours and settings increase, so do the challenges for students; and 5) there is interest in developing alternative ObHr experiences.

Discussion and Conclusion.
There was consensus among all stakeholder groups regarding ObHr's value for exploring the profession of physical therapy and helping applicants determine if the profession is a good fit. Respondents highlighted the value of observing in a variety of practice settings. Perspectives differed between AC members and students regarding the impact of ObHr on admissions decision making. Students reported a variety of personal and organizational challenges associated with ObHr completion. Physical therapy programs should reexamine their current ObHr practices and consider alternative methods that support all applicants in their pursuit of a career in physical therapy.
Virtual Reality Instructional Design in Orthopedic Physical Therapy Education: A Randomized Controlled Trial
Authors: Hartstein Aaron J. , Zimney Kory , Verkuyl Margaret , Yockey Jean , Berg-Poppe Patti 
Published: February 2022

Introduction.
Effective clinical decision-making (CDM) skills are essential for physical therapist practice. The purpose of this study was to compare the effects of virtual reality (VR) patient simulation with those of a traditional standardized patient simulation on the CDM of student physical therapists (SPTs).

Review of Literature.
Authentic experiential learning opportunities are needed to promote CDM. The effects of VR simulation on the CDM of SPTs are unknown.

Subjects.
Fifty-nine first-year SPTs participated in this study.

Methods.
A randomized controlled trial compared the effects of VR with those of standardized patient simulation on several aspects of CDM in 59 first-year students after an upper extremity orthopedic unit. Perceived CDM abilities and metacognitive awareness were assessed before and after allocated instruction. Diagnostic accuracy and diagnostic efficiency were measured during instruction. Student engagement was assessed immediately after instruction and psychomotor skill was assessed 1 week later.

Results.
Statistically significant within-group differences in CDM were noted after both VR and standardized patient instruction, but no between-group differences were found. Although effect sizes were considered large with either learning experience, the observed experimental effect was greater after a VR experience. No between-group differences were found between metacognitive awareness, diagnostic accuracy, or psychomotor skill assessment. Diagnostic efficiency was statistically significantly greater in the standardized patient condition, while engagement was significantly greater in the VR condition.

Discussion and Conclusion.
Measures of perceived CDM improved regardless of instructional method; however, the effect size was greater after VR. These findings reveal 2 effective experiential learning options to promote CDM. These results exemplify the normative trajectory of CDM development and recommendations for differentiated curricular instruction. Although resource intensive initially, VR technology appears capable of advancing CDM skills in an efficient manner that may minimize future cost and the faculty facilitation associated with standardized patient instruction.
GLP-1 receptor agonists and cardiovascular outcomes in patients with type 2 diabetes: Clinical evidence and best practice
Authors: Coke Lola A. , Deedwania Prakash C. , Hinnen Debbie , Magwire Melissa , Miller Nancy H. 
Published: February 2022

ABSTRACT
Cardiovascular disease (CVD) is a major cause of death and disability among people with type 2 diabetes (T2D), presenting a significant impact on longevity, patient quality of life, and health care costs. In the United States, attainment of recommended glycemic targets is low and T2D-related cardiovascular complications remain a significant burden. Many glucose-lowering treatment options are available, but glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 (SGLT-2) inhibitors are recommended in recent guidelines as the preferred add-on therapy to metformin to improve glycemic control. This is particularly the case for patients with T2D and established atherosclerotic CVD, at high risk of atherosclerotic CVD, and/or with chronic kidney disease. Recommendations were based on GLP-1RA and SGLT-2 inhibitor cardiovascular outcomes trials (CVOTs), which consistently showed that these agents pose no additional cardiovascular risk compared with placebo. Three GLP-1RAs (liraglutide, dulaglutide, and subcutaneous semaglutide) demonstrated significantly lower major adverse cardiovascular events versus placebo and are now approved for this indication. However, to realize improvement in outcomes in the clinical setting, organized, systematic, and coordinated approaches to patient management are also needed. For example, nurse-led diabetes self-management education and support programs have been shown to be effective. This article explores T2D management with emphasis on cardiovascular risk and CVOTs performed to date and reviews the clinical experience with GLP-1RAs for managing hyperglycemia and their impact on cardiovascular risk. In addition, practical guidance is given for key health care providers involved in the care of patients with T2D with cardiovascular risk outside of diabetes clinics/endocrinology centers.
Understanding the nomenclature of mitochondrial DNA mutations through examples of two specific disease entities: Mitochondrial encephalopathy with lactic acidosis and stroke-like episodes and Leber hereditary optic neuropathy
Authors: Heuer Beth , Seibert Diane C. 
Published: February 2022

ABSTRACT
Mitochondrial diseases are genetic disorders that can arise either from maternally inherited mitochondrial DNA (mtDNA) or from mutations in nuclear DNA. This article is the second in a series of papers reviewing mitochondrial genetics and several of the disorders associated with mitochondrial gene variants. With a prevalence of 1:∼4,300 persons, mitochondrial disorders are diagnostic entities with which nurse practitioners should be familiar. In describing genetic mutations, numbering nucleotides (nuclear or mtDNA) is critical for communicating exactly where a variation has occurred in a stretch of nucleotides. This article discusses the nomenclature associated with mtDNA mutations, using the examples of mutations causing mitochondrial encephalopathy with lactic acidosis and stroke-like episodes and Leber hereditary optic neuropathy. Pathophysiology, symptoms, and treatment options for these disease entities are discussed.
The efficacy of Tai Chi for depression
Authors: He Guojian , Zhang Xiucai , Yan Ting , Wang Jiayi , Li Qi , Liu Tianyu , Oh Youn-Poong 
Published: February 2022

Abstract

Background:
Depression is a commonly occurring and recurrent mental disorder cross the world. Tai Chi is a traditional Chinese mind-body exercise which could be used to treat mental disorders including depression. This study aimed to conduct a systematic review and meta-analysis to assess the efficiency of Tai Chi for patients with depression.

Methods:
This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol statement. Literature will be searched at PubMed, EMBASE, Web of Science, Cochrane Library, China Biology Medicine Database, China National Knowledge Infrastructure, Technology Journal Database, and Wan Fang database from the start date to September 2021. The Review Manager 5.3 software will be used to manage literature. After literature screening, 2 reviewers will extract data from the respects of general information, methodology, and results. The data analysis will be conducted with Review Manager and Stata 16 software, and the publication bias and literature quality will be both evaluated.

Results:
The results will contain the evaluation of clinical efficacy of Tai Chi practice for depression, as well as the assessment of literature quality and publication bias.

Conclusion:
The current review will provide new evidence on whether and to what extent patients with depression can benefit from Tai Chi practice.
Registration number: DOI: 10.17605/OSF.IO/AUDNQ (https://osf.io/audnq).
Choroidal vascularity index and thickness in sarcoidosis
Authors: Ugurlu Erhan , Pekel Gokhan , Akbulut Selen , Cetin Nazli , Durmus Sinan , Altinisik Goksel 
Published: February 2022

Abstract
Sarcoidosis is a multisystem granulomatous disease which is observed worldwide. Sarcoidosis is one of the common causes of ocular inflammation. The choroidal vascularity index, defined as the ratio of the luminal area to the total choroidal area, is used as one of the biomarkers for assessing the choroid vascular state. We aimed to compare choroidal vascularity index and thickness measurements between sarcoidosis patients and healthy controls.
Thirty-one patients with sarcoidosis and 31 age-gender matched healthy participants were recruited in this cross-sectional and comparative study. Choroidal vascularity index was defined as the ratio of luminal area to total choroidal area after binarization on optical coherence tomography images. Anterior segment examinations included central corneal thickness, corneal volume, anterior chamber depth, anterior chamber volume, and iridocorneal angle. Spectral-domain optical coherence tomography was used to measure peripapillary retinal nerve fiber layer thickness, choroidal thickness, and retinal vessel caliber.
The mean choroidal vascularity index value was 61.6% in sarcoidosis patients and 62.4% in healthy controls (P = .69). The choroidal vascularity index and thickness were significantly correlated in both sarcoidosis (r = 0.41, P = .026) and control groups (r = 0.51, P = .006). Both the sarcoidosis and control groups had similar measured values for central corneal thickness, corneal volume, anterior chamber depth, anterior chamber volume, and iridocorneal angle (P > .05). Mean retinal nerve fiber layer, retinal arteriole and venule caliber, and choroidal thickness measurements did not differ significantly between the groups (P > .05).
Sarcoidosis patients in quiescent period have similar choroidal vascularity index and thickness with healthy controls.