bluuebunny/crossref_metadata_2025 huggingface dataset:
Chitosan and Aloe Vera decorated nanoparticulate system loaded with Minoxidil as a suggested topical formulation for alopecia therapy
Authors: Mohamad Ebtesam A , Gad Amany M , Abd El-Rhman Rana H , Darwish Mirhane M
Published: April 2023

Minoxidil (Mxd) is a common medication used for hair regrowth in patients exhibiting different types of alopecia, especially androgenetic alopecia (AGA), but it has some negative aspects such as causing adverse effects and having limited permeation through the outer skin layers. In this study, minoxidil was encapsulated into niosomes and then loaded into chitosan nanoparticles and Aloe vera for creating a nanocomposite (Cs@Alo/Nio-Mxd), which will be used as a topical formulation to overcome these difficulties. The various prepared samples were physico-chemically characterised by their loading efficiency, TEM, SEM, zeta potential, FTIR and in vitro release profiles. The hair growth potential of the prepared formulations was evaluated by an in vivo study using rats with induced alopecia. Thirty-six rats with induced alopecia were randomised into six groups of six rats each. Group 1 (Negative control): rats served as normal and were treated with normal saline, Group 2: rats were treated with topical application of empty nanocomposites. Group 3 (Positive control): rats were treated with topical application of 5% Mxd, Group 4: rats were treated with topical application of (Cs-Mxd NPs), Group 5: rats were treated with topical application of (Cs@Alo-Mxd NPs). Group 6: rats were treated with topical application of (Cs@Alo/Nio-Mxd) nanocomposite. All formulations were applied once daily for 21 days. The treated skin was observed, photographed, and its histological features were examined. Results specified that Cs@Alo/Nio-Mxd nanocomposite could be preferentially deposited into the hair follicles, causing a significant increase (p < 0.05) in skin thickness, total hair follicle number per field, hair follicle diameter, hypodermis hair follicle number and anagen induction percentage.
In situ strain-induced phase transition and defect engineering in CVD-synthesized atomically thin MoS2
Authors: Zhang Hanwen , Poh Eng Tuan , Lim Sharon Xiaodai , Zhang Yimin , Qin Hongye , Xie Haonan , He Chunnian , Sow Chorng Haur
Published: April 2023

Alkali metal halides have recently received great attention as additives in the chemical vapor deposition (CVD) process to promote the growth of transition metal dichalcogenides (TMDs). However, the multi-faceted role of these halide salts in modulating the properties and quality of TMD monolayers remains mechanistically unclear. In this study, by introducing excessive gaseous sodium chloride (NaCl) into the CVD system, we demonstrate that preferential NaCl deposition along the monolayer edges causes large in situ strain that can invoke localized domains of high defect density and 2H to 1T phase transition. High-resolution scanning transmission electron microscopy, Raman mapping and molecular dynamics simulations revealed that higher NaCl concentrations can promote the coalescence of independent local strain domains, further increasing the 1T/2H phase ratio and defect density. Furthermore, excessive NaCl was also proven by density functional theory calculations to convert thermodynamic growth to kinetic growth, accounting for the unique cloud-shaped MoS2 crystals acquired. Compared with post-growth strain processing methods, this one-step approach for phase and defect engineering not only represents a deeper understanding of the role that NaCl plays in the CVD process, but also provides a convenient means to controllably synthesize conductive/defect-rich materials for further electrocatalysis and optoelectronic applications.
Nanomechanical absorption spectroscopy of 2D materials with femtowatt sensitivity
Authors: Kirchhof Jan N , Yu Yuefeng , Yagodkin Denis , Stetzuhn Nele , de Araújo Daniel B , Kanellopulos Kostas , Manas-Valero Samuel , Coronado Eugenio , van der Zant Herre , Reich Stephanie , Schmid Silvan , Bolotin Kirill I
Published: April 2023

Nanomechanical spectroscopy (NMS) is a recently developed approach to determine optical absorption spectra of nanoscale materials via mechanical measurements. It is based on measuring changes in the resonance frequency of a membrane resonator vs. the photon energy of incoming light. This method is a direct measurement of absorption, which has practical advantages compared to common optical spectroscopy approaches. In the case of two-dimensional (2D) materials, NMS overcomes limitations inherent to conventional optical methods, such as the complications associated with measurements at high magnetic fields and low temperatures. In this work, we develop a protocol for NMS of 2D materials that yields two orders of magnitude improved sensitivity compared to previous approaches, while being simpler to use. To this end, we use mechanical sample actuation, which simplifies the experiment and provides a reliable calibration for greater accuracy. Additionally, the use of low-stress silicon nitride membranes as our substrate reduces the noise-equivalent power to

NEP

=
890

fW

H
z

−
1

, comparable to commercial semiconductor photodetectors. We use our approach to spectroscopically characterize a 2D transition metal dichalcogenide (WS2), a layered magnetic semiconductor (CrPS4), and a plasmonic super-crystal consisting of gold nanoparticles.
The implementation of Shannon-limited polar codes-based information reconciliation for quantum key distribution
Authors: Guo Junbin , Tang Bangying , Lai Tingqin , Liang Xiaolin , Zhang Siyuan , Tian Zhiyu , Huang Jinquan , Yuan Xuelin , Yu Wanrong , Liu Bo , Luo Shaobo , Sun Shihai
Published: April 2023

Quantum key distribution (QKD) gives a way to generate unconditionally secure keys for two remote users, Alice and Bob. Information reconciliation (IR), which can correct the errors caused by the imperfections of the QKD systems, is a critical component in QKD. Due to the high-security requirements and large volumes of data processing, robustness and efficiency are two main factors that must be considered for the implementation of IR. The polar codes-based IR has several potential advantages, such as capacity to reach Shannon-limit, high IR efficiency, and low computational complexity. Although CPU-based IR is always implemented in most of the previous works, it is not the optimal implementation in terms of performance and power dissipation. To the best of our knowledge, there is still no work to build a special-purpose hardware module for polar codes-based IR. In this paper, a dedicated design of hardware accelerator is first proposed for polar codes-based IR, in which the block-checked successive cancellation list (SCL) algorithm is used to verify the consistency of the sifted keys, and the overall failure probability of IR is significantly reduced. The proposed design is constructed into a partially-unrolled parallel architecture to accelerate the core decoder as well as balance the resource utilization. Furthermore, the hardware implementation is completed based on Xilinx Zynq UltraScale+ XCZU5EV MPSoC platform and achieves an IR throughput of 15 Mbps with a block length of 212, while less than

20
%

of the amount of on-chip resources are used in other previous designs of SCL decoder. The proposed design can provide a real-time, low-cost solution for IR in QKD systems, and enhance the performance of QKD.
Stratification of ovarian cancer patients from the prospect of drug target-related transcription factor protein activity: the prognostic and genomic landscape analyses
Authors: Su Dongqing , Zhang Haoxin , Xiong Yuqiang , Wei Haodong , Yu Yao , Li Honghao , Wang Tao , Zuo Yongchun , Yang Lei
Published: April 2023

The expression and activity of transcription factors, which directly mediate gene transcription, are strictly regulated to control numerous normal cellular processes. In cancer, transcription factor activity is often dysregulated, resulting in abnormal expression of genes related to tumorigenesis and development. The carcinogenicity of transcription factors can be reduced through targeted therapy. However, most studies on the pathogenic and drug-resistant mechanisms of ovarian cancer have focused on the expression and signaling pathways of individual transcription factors. To improve the prognosis and treatment of patients with ovarian cancer, multiple transcription factors should be evaluated simultaneously to determine the effects of their protein activity on drug therapies. In this study, the transcription factor activity of ovarian cancer samples was inferred from virtual inference of protein activity by enriched regulon algorithm using mRNA expression data. Patients were clustered according to their transcription factor protein activities to investigate the association of transcription factor activities of different subtypes with prognosis and drug sensitivity for filtering subtype-specific drugs. Meanwhile, master regulator analysis was utilized to identify master regulators of differential protein activity between clustering subtypes, thereby identifying transcription factors associated with prognosis and assessing their potential as therapeutic targets. Master regulator risk scores were then constructed for guiding patients’ clinical treatment, providing new insights into the treatment of ovarian cancer at the level of transcriptional regulation.
Social Work with Interpreters: Using Practitioner Knowledge to Improve Practice
Authors: Pollock Sarah
Published: April 2023

Interpreters are crucial to enabling individuals with limited English proficiency (LEP) to navigate the social welfare system, as they facilitate the development of relationships between this population and social workers. This article utilises primary data to analyse the interactive relationship between interpreters, social workers and service users with LEP with a view to better management of these three-way interactions and improved engagement with the LEP population, thus improving health and social care outcomes for this group. A social work education and workforce development review alongside online focus groups with professionals provided data to develop three broad categories: knowledge, values and skills. These categories house seven sub-themes, comprising trust/confidentiality, relationships, role knowledge, cultural knowledge, briefing and debriefing, values and attitude, and practical knowledge. Findings suggest that social workers saw interpreters as a barrier to their relationship with families rather than as a facilitator to communication. Enhancing practitioner knowledge, values and skills is essential to changing this narrative and improving relationships between professionals and in turn with the LEP population. By framing communication as a Human Rights issue, and prioritising language in social work education and workforce development, this is possible within existing legal and regulatory frameworks.
Management of traditional risk factors for the development and progression of chronic kidney disease
Authors: Lo Robin , Narasaki Yoko , Lei Sean , Rhee Connie M
Published: April 2023

Chronic kidney disease (CKD) and its downstream complications (i.e. cardiovascular) are a major source of morbidity worldwide. Additionally, deaths due to CKD or CKD-attributable cardiovascular disease account for a sizeable proportion of global mortality. However, the advent of new pharmacotherapies, diagnostic tools, and global initiatives are directing greater attention to kidney health in the public health agenda, including the implementation of effective strategies that (i) prevent kidney disease, (ii) provide early CKD detection, and (iii) ameliorate CKD progression and its related complications. In this Review, we discuss major risk factors for incident CKD and CKD progression categorized across cardiovascular (i.e. hypertension, dyslipidemia, cardiorenal syndrome), endocrine (i.e. diabetes mellitus, hypothyroidism, testosterone), lifestyle (i.e. obesity, dietary factors, smoking), and genetic/environmental (i.e. CKDu/Mesoamerican nephropathy, APOL1, herbal nephropathy) domains, as well as scope, mechanistic underpinnings, and management.
Witness for resolution: post-conflict quadratic affiliation in semi-free ranging pigs
Authors: Norscia Ivan , Collarini Edoardo , Robino Carlo , Chierto Elena , Cordoni Giada
Published: April 2023

In social mammals, post-conflict resolution can involve the reunion of former opponents (reconciliation), spontaneous/solicited post-conflict affiliation of a third party with either opponent (triadic contacts), and affiliation between other individuals (hereafter bystanders; quadratic contacts). Quadratic contacts—possibly informing complex cognitive abilities—have been neglected in post-conflict studies. We investigated quadratic affiliation in semi-free ranging pigs Sus scrofa, at the ethical farm Parva-Domus (Cavagnolo, Italy). Kinship was known. We collected behavioral data on adult pigs (n = 104) via video recordings (43 h) followed by video analyses. Affiliative and anxiety behaviors between bystanders were collected under post-conflict (PC; following a conflict between non-bystanders) and matched-control (MC; no conflict) conditions. Quadratic affiliation was present in pigs, as bystanders affiliated more in PC than MC, and such affiliation was followed by a decrease in the anxiety behaviors of both the interacting bystanders. Thus, quadratic contacts may be partly aimed at reducing one’s own anxiety (intrinsic regulation). Quadratic affiliation was highest between closely related bystanders, which suggests that such affiliation may be most effective when close kin is involved. Quadratic affiliation was lowest after reconciliation and spontaneous triadic contacts. This suggests that direct peacemaking between opponents and spontaneous triadic contacts with close kin may most likely replace quadratic affiliation. Hence, pigs can be influenced by the negative events that affect other pigs—but not themselves—and their response may be modulated by social factors. Such non-random quadratic affiliation may point toward the presence of elements of social appraisal abilities in pigs.
The Mummy Explorer—a self-regulated open-access online teaching tool
Authors: Furtwängler Anja , Baumann Chris , Majander Kerttu , Wilkin Shevan , Tomoum Nadja , Rühli Frank , Jaeggi Adrian V , Eppenberger Patrick , Bender Nicole , Schuenemann Verena J
Published: April 2023

Background and objectives

Virtual teaching tools have gained increasing importance in recent years. In particular, the COVID-19 pandemic has reinforced the need for media-based and self-regulated tools. What is missing are tools that allow us to interlink highly interdisciplinary fields such as evolutionary medicine and, at the same time, allow us to adapt content to different lectures.

Methodology

We designed an interactive online teaching tool, namely, the Mummy Explorer, using open-access software (Google Web Designer), and we provided a freely downloadable template. We tested the tool on students and lecturers of evolutionary medicine using questionnaires and improved the tool according to their feedback.

Results

The tool has a modular design and provides an overview of a virtual mummy excavation, including the subfields of palaeopathology, paleoradiology, cultural and ethnographic context, provenance studies, paleogenetics, and physiological analyses. The template allows lecturers to generate their own versions of the tool for any topic of interest by simply changing the text and pictures. Tests undertaken with students of evolutionary medicine showed that the tool was helpful during their studies. Lecturers commented that they appreciated having a similar tool in other fields.

Conclusions and implications

Mummy Explorer fills a gap in the virtual teaching landscape of highly interdisciplinary fields such as evolutionary medicine. It will be offered for free download and can be adapted to any educational topic. Translations into German and possibly other languages are in progress.
A new hypothesis for the origin of the lager yeast Saccharomyces pastorianus
Authors: Hutzler Mathias , Morrissey John P , Laus Andreas , Meussdoerffer Franz , Zarnkow Martin
Published: April 2023

Saccharomyces pastorianus, which is responsible for the production of bottom-fermented lager beer, is a hybrid species that arose from the mating of the top-fermenting ale yeast Saccharomyces cerevisiae and the cold-tolerant Saccharomyces eubayanus around the start of the 17th century. Based on detailed analysis of Central European brewing records, we propose that the critical event for the hybridization was the introduction of top-fermenting S. cerevisiae into an environment where S. eubayanus was present, rather than the other way around. Bottom fermentation in parts of Bavaria preceded the proposed hybridization date by a couple of hundred years and we suggest that this was carried out by mixtures of yeasts, which may have included S. eubayanus. A plausible case can be made that the S. cerevisiae parent came either from the Schwarzach wheat brewery or the city of Einbeck, and the formation of S. pastorianus happened in the Munich Hofbräuhaus between 1602 and 1615 when both wheat beer and lager were brewed contemporaneously. We also describe how the distribution of strains from the Munich Spaten brewery, and the development by Hansen and Linder of methods for producing pure starter cultures, facilitated the global spread of the Bavarian S. pastorianus lineages.
Neighborhood Social Environment and Self-Perceptions of Aging
Authors: Choi Eun Young , Zelinski Elizabeth M , Ailshire Jennifer
Published: April 2023

Background and Objectives

Self-perceptions of aging (SPA) are associated with health and well-being later in life. Although prior studies have identified individual-level predictors of SPA, the role of neighborhood social context in SPA remains largely unexplored. A neighborhood social environment may act as a critical avenue for older adults to remain healthy and socially active, contributing to their evaluations of how they grow old. The present study aims to fill the previous research gap by examining the relationship between neighborhood social environment and SPA, and how age may moderate this relationship. This study is guided by Bronfenbrenner’s Ecology of Human Development theory and Lawton’s Ecological Model of Aging, positing that an individual’s aging experience is deeply rooted in their residential environment.

Research Design and Methods

Our sample includes 11,145 adults aged 50+ from the 2014 and 2016 waves of the Health and Retirement Study. We included 4 social and economic aspects of neighborhoods: (1) neighborhood poverty; (2) percentage of older adults; (3) perceived social cohesion; and (4) perceived disorder.

Results

Multilevel linear regression models showed that respondents in neighborhoods with higher percentages of the older population and with perceptions of high neighborhood disorder reported more negative SPA. Those who perceived their neighborhoods as more socially cohesive reported more positive SPA. Controlling for individual socioeconomic and health status, only neighborhood social cohesion remained significant. We also found significant interaction effects between neighborhood social cohesion and age: The effects of neighborhood cohesion on SPA were stronger in middle age than in old age.

Discussion and Implications

Our findings provide insights into how neighborhood social context is associated with SPA, suggesting that a socially cohesive neighborhood may be important to promote more favorable perceptions of aging, particularly for middle-aged residents.
Understanding Nuance and Ambivalence in Intergenerational Relationships Through Fiction
Authors: French Jade Elizabeth , Lovatt Melanie , Wright Valerie
Published: April 2023

Background and Objectives

The term “intergenerational relationships” is widely used in gerontological literature and age-related policies. However, discussions of the term often tell us surprisingly little about what it means or why it matters. We suggest that this is due to a reductivism and instrumentalism in 2 main discourses within which intergenerational relationships are usually discussed. First, intergenerational relationships are often conceptualized through a binary “conflict/solidarity” lens, reinforcing an entrenched “generationalism”. Second, they are predominantly constructed as a problem to be addressed within debates on how to tackle intergenerational segregation. Neither of these discourses provides much room for a more nuanced understanding of how intergenerational relationships are experienced or why they are meaningful. In this paper, we discuss how fictional narratives can introduce imagination and a richer vocabulary into discourses concerning how people of different ages relate to each other.

Research Design and Methods

We present findings from reading groups where adults discussed novels depicting themes of older age, intergenerational relationships, and time.

Results

In discussing the fictional narratives and characters, participants reflected on the significance and meaning of intergenerational relationships in ways that went beyond dichotomous and instrumentalist discourses. Drawing on the concept of lived ambivalence, we argue that fictional representations of intergenerational themes can elicit more meaningful reflections on the complexities and contradictions of relationships across age groups.

Discussion and Implications

We conclude that a more nuanced understanding of intergenerational interaction can inform gerontological discourses and policy, but also that gerontological awareness of social challenges concerning age relations can inform interpretations of fictional narratives.
A Derived Equivalence of the Libgober–Teitelbaum and the Batyrev–Borisov Mirror Constructions
Authors: Malter Aimeric
Published: April 2023

In this paper, we study a particular mirror construction to the complete intersection of two cubics in $\operatorname{{\mathbb{P}}}^{5}$, due to Libgober and Teitelbaum. Using variations of geometric invariant theory and methods of Favero and Kelly, we prove a derived equivalence of this mirror to the Batyrev–Borisov mirror of the complete intersection.
Minimum Wages and Labour Supply in an Emerging Market: The Case of Mauritius
Authors: Asmal Zaakhir , Bhorat Haroon , Kanbur Ravi , Ranzani Marco , Paci Pierella
Published: April 2023

This paper investigates the effect of multiple minimum wages, known as remuneration orders, on employment and working hours in Mauritius. Using data between 2005 and 2014, the analysis finds no effect on overall employment and different effects in sign for men and women. The minimum wage has a positive long-term effect on women's employment (0.141) and a negative effect on male employment (−0.097). The estimated employment elasticity magnitudes for men and women are within the range of elasticities found in previous studies of employment effects of minimum wages in low- and middle-income countries. The aggregate employment effect of the minimum wage in Mauritius is not significant, due to the larger share of men who are employed. The extensive margin effect of minimum wages is also associated with a 2.2% increase in average working hours for men but a 1.3% decline in average working hours for women in the covered sector. In the uncovered sector, the significant positive effect along the intensive margin, estimated at 4.6%, is driven by changes in labour supply among men.
High-protein dried distillers grains in dog diets: diet digestibility and palatability, intestinal fermentation products, and fecal microbiota
Authors: Kaelle Gislaine Cristina Bill , Bastos Taís Silvino , Fernandes Eduarda Lorena , de Souza Renata Bacila Morais dos Santos , de Oliveira Simone Gisele , Félix Ananda Portella
Published: April 2023

This study aimed to evaluate the effects of high-protein dried distillers grains (HPDDG) on palatability and metabolizable energy (ME) of the diet, apparent total tract digestibility (ATTD) of nutrients and energy, intestinal fermentation products, and fecal microbiota in dogs. Four diets containing 0, 70, 140, and 210 g/kg of HPDDG were manufactured. To evaluate the ME and the ATTD of macronutrients of HPDDG itself, an additional test diet was manufactured containing 70% of the control diet formula (0 g/kg) and 300 g/kg of HPDDG. Fifteen adult Beagle dogs were distributed in a randomized block design, with two periods of 15 d each (n = 6). The HPDDG digestibility was obtained using the Matterson substitution method. For the palatability test, 16 adult dogs were used, comparing the diets: 0 vs. 70 g/kg of HPDDG and 0 vs. 210 g/kg of HPDDG. The ATTD of HPDDG were: dry matter = 85.5%, crude protein = 91.2%, and acid-hydrolyzed ether extract = 84.6% and the ME content was 5,041.8 kcal/kg. The ATTD of macronutrients and ME of the diets and the fecal dry matter, score, pH, and ammonia of the dogs did not differ among treatments (P > 0.05). There was a linear increase in the fecal concentrations of valeric acid with the inclusion of HPDDG in the diet (P < 0.05). Streptococcus and Megamonas genera reduced linearly (P < 0.05), and Blautia, Lachnospira, Clostridiales, and Prevotella genera showed a quadratic response to the inclusion of HPDDG in the diet (P < 0.05). Alpha-diversity results showed an increase (P < 0.05) in the number of operational taxonomic units and Shannon index and a trend (P = 0.065) for a linear increase in the Chao-1 index with the dietary inclusion of HPDDG. Dogs preferred the 210 g/kg diet over the 0 g/kg HPDDG diet (P < 0.05). These results demonstrate that the HPDDG evaluated does not affect the utilization of nutrients in the diet, but it may modulate the fecal microbiome of dogs. In addition, HPDDG may contribute to diet palatability for dogs.
PROMIS-25 Reliability and Validity Among Children Living with Burn Injury: A Burn Model System National Database Study
Authors: Bamer Alyssa M , McMullen Kara , Humbert Andrew , Kazis Lewis , Ryan Colleen M , Schneider Jeffrey C , Stewart Barclay T , Suman Oscar E , Amtmann Dagmar
Published: April 2023

This study examined the reliability and validity of the Patient Reported Outcomes Measurement System (PROMIS)-25, a profile instrument consisting of four-item fixed short forms for six health domains, in children living with burn injury. Data were provided by children participating in a multi-center longitudinal study of outcomes after burn injury. Floor and ceiling effects, unidimensionality, internal consistency, reliability, and differential item functioning (DIF) of the PROMIS-25 Profile v.2.0 were examined. Correlations with other established measures were calculated to assess concurrent validity. Children (n = 256) between the ages of 8–18 years with moderate to severe injury provided responses on PROMIS-25 domains. All PROMIS-25 domains showed high internal consistency. Substantial portions of the sample reported no symptoms (anxiety [58.2%], depressive symptoms [54.6%], fatigue [50.8%], pain [60.1%]). There was a large ceiling effect on peer relationships (46.8%) and physical function mobility (57.5%). One-factor confirmatory factor analyses supported unidimensionality for all domains. Reliability was sufficient for group mean comparisons (>0.8) across at least some trait levels for most domains except fatigue and anxiety. No DIF with respect to burn status was detected when comparing the burn sample to the PROMIS pediatric general U.S. population testing sample. These results provide evidence of reliability and validity of PROMIS-25 scores among children living with burn injury. Reliability of domains was low to moderate and would likely be improved, and ceiling effects reduced for some domains, by administering the PROMIS-37, which includes six items per domain.
Effects of temperature and pressure on the wave responses of deep carbonate reservoirs
Authors: Ruan Chuantong , Li Fei , Ba Jing , Carcione José M , Wu Chunfang
Published: April 2023

Deep carbonate reservoirs are subject to in-situ conditions of high temperature and high pressure. We consider six water-saturated dolomite specimens from these reservoirs and perform ultrasonic experiments to obtain the P- and S-wave waveforms and velocities under different pressure and temperature conditions. The P-wave attenuation is estimated using the spectral-ratio method. The results show that with the increase of temperature, the velocities slightly decrease and attenuation increases. At effective pressures <40 MPa, the P-wave velocities increase sharply with pressure and then approximately linearly at higher pressures, while attenuation decreases gradually with pressure. The crack porosity as a function of pressure is obtained from the experimental data. The P-wave velocities decrease with this porosity while attenuation shows an opposite behavior. Then, a multiscale poroelasticity model considering micro-, meso- and macro-scale fluid-flow mechanisms is proposed to analyze the effects of the fluid properties, temperature and crack content on the wave responses. The model results agree well with the experimental data at different pressures, which provides a theoretical basis for the analysis of broadband wave velocity dispersion and attenuation phenomena of carbonate reservoirs and underground porous media in general.
Association of chronic opioid therapy with emergency department visits and hospitalizations among super-utilizers
Authors: Surbhi Satya , Harris Leonard J , Box Amanda , Bailey James E
Published: April 2023

Objectives

Patients with complex medical needs and high inpatient utilization frequently use opioids for non-malignant chronic pain. We examine the association between chronic opioid therapy and healthcare utilization among high-need, high-cost patients insured by Medicare.

Methods

This study is a retrospective cohort study of Medicare beneficiaries in a medically underserved metropolitan area. Patients were included in the study if they had ≥2 hospitalizations or ≥1 hospitalization and ≥2 emergency department (ED) visits in a 6-month-period preceding an index hospitalization between July 2011 and June 2014. Exclusion criteria included substance abuse, psychosis and malignancy. Multivariable negative binomial regression models assessed associations between baseline opioid medication use and subsequent ED and hospital visits for the study population and two subgroups: (1) those with chronic pain and (2) those with both chronic pain and a primary care provider.

Key findings

The majority of high-need, high-cost patients filled opioid prescriptions of ≥7-day supply (51%). Yet only 2.7% of patients with chronic pain received an opioid prescription of ≥7-day supply from an ED provider in the baseline period. Overall (n = 677), receipt of a ≥7-day opioid supply was positively associated with subsequent ED utilization but not subsequent hospitalization. Among those with chronic pain and ≥1 primary care practice visit (N = 481), opioid use was associated with inpatient utilization but not ED utilization. Receipt of adjuvant pain prescriptions was not protective of hospitalizations or ED visits.

Conclusions

Chronic pain and opioid therapy are common among high-need, high-cost patients and they are independently associated with higher ED and hospital utilization. Novel patient-centred outpatient pain management strategies have potential to reduce inpatient care in this population.
The link between knowledge and practices in relation to herbal supplement use: for a rapid transfer of knowledge in the field of phytovigilance and pharmacovigilance health care systems
Authors: Abdulla Naseem Mohammed , Blair Iain , Ádám Balázs , Oulhaj Abderrahim , Jairoun Ammar Abdulrahman
Published: April 2023

Objectives

The use of health supplements (HSs) is increasing globally. It is essential to better understand health care providers’ knowledge, attitudes and practices (KAP) regarding HS use and their associated adverse events (AEs). Thus, we conducted a cross-sectional study of health care professionals in Dubai.

Methods

Four hundred and twenty-seven health care professionals from hospitals, clinics (public and private) and community pharmacies completed an online questionnaire that collected demographic data and enquired about their experience with HSs. Simple descriptive statistics were used to characterise participants. Based on 10 questions, a summary score was created for the overall KAP of respondents. For each question, an affirmative response scored 1 and a negative response scored 0. A total score of 10 was therefore obtainable; logistic regression was used to identify the correlates of those scores.

Key findings

The results showed that 18.3% (n = 78) of respondents had good KAP concerning HS, 38.9% (n = 166) had fair KAP and 42.9% (n = 183) had poor KAP. Scores were significantly higher among non-UAE nationals compared with UAE nationals (P = 0.001), among physicians and pharmacists compared with other health care practitioners (P = 0.000), and among practitioners with more than 6 years of experience compared to those with 6 years of experience or less (0.017). No association was found between KAP scores and age, marital status, employment status or educational level.

Conclusion

Despite the popularity and widespread use of HS among the general population in Dubai, knowledge of HSs and their possible adverse effects is limited among health professionals. This was the first study to investigate this topic in the United Arab Emirates. Further policies are needed to reduce the potential for adverse events related to HS use. Additionally, educational programs are required for health care professionals to address current low levels of knowledge.
Physicians’ attitudes toward expanding the role of community pharmacists in Al Ain, United Arab Emirates
Authors: AlAhmad Mohammad M , Sadeq Aya , ZainAlabdin Sham , Abdelsabour Moatasem , Muhaisen Attaallah , Fathelrahman Albaraa , Alnajjar Munther S , AbuRuz Salah
Published: April 2023

Objectives

To explore physicians’ attitudes toward expanding the role of community pharmacists to include traditional and advanced pharmaceutical care activities. In addition, the study assessed factors influencing physicians’ attitudes.

Methods

A cross-sectional study was conducted among physicians in Al Ain, United Arab Emirates (UAE), in 2019. Participants were randomly selected and were practicing physicians in Al Ain. A questionnaire was hand-delivered and consisted of four sections: demographic information, general attitudes, attitudes towards traditional and attitudes towards advanced pharmaceutical care activities.

Key findings

Two hundred twenty-nine (response rate ~92.0%) practicing physicians agreed to participate in this study. The majority (95.1%, n = 218) agreed with expanding pharmacists’ activities beyond their traditional role and facilitating pharmacists’ access to patients’ medical records (85.4%, n = 196). Physicians’ overall attitudes toward traditional pharmaceutical care were positive (~80%, n = 183), particularly regarding improving patient adherence, providing drug information, patient counselling, and identifying, monitoring, and resolving drug-related problems. On the other hand, physicians were partially accepting of pharmacists’ involvement in advanced pharmaceutical care services (~46%, n = 108). The majority of them considered pharmacists competent in generic substitution (75.6%, n = 173) and in adjusting drug therapy based on agreed protocols (56.1%, n = 128). However, they considered them less competent for therapeutic substitution (41.5%, n = 95), treating certain minor illnesses (41.5%, n = 95), and refilling repeat prescriptions independently (22%, n = 50). Overall, physicians’ attitudes were positive toward 9 out of 12 expanded activities for community pharmacists.

Conclusions

This study has shown that UAE physicians have agreed that the pharmacist’s role should extend beyond dispensing medications. Physicians have also positive attitudes toward expanding community pharmacists’ activities to include all of the traditional pharmaceutical care activities. On the other hand, physicians had a negative attitude toward most of the advanced activities.
Tetramethylpyrazine contributes to the neuroprotection in a rodent epileptic model of pentylenetetrazole-induced kindling
Authors: Danduga Ravi Chandra Sekhara Reddy , Shaik Habbeb Banu , Polopalli Subramanyam , Kola Phani Kumar , Kanakaraju Vijaya Kishore , Kandaswamy Surabhi
Published: April 2023

Objectives

In this study, tetramethylpyrazine (TMP) was evaluated for its therapeutic potential as an alternative therapy for epileptogenesis and its associated comorbidities in rats.

Methods

The sub-convulsant dose of pentylenetetrazole (PTZ) (35 mg/kg, intraperitoneally) was injected on alternative days to produce kindling for 32 days and observed for seizure score percent of kindled animals in each group. After kindling, the animals were evaluated in models of anxiety, memory and predictive of depression. The neuroprotective effect of TMP was assessed by estimating the biochemical parameters in the cortex and hippocampus of the brain. Histopathological alterations were also observed in the cortex and hippocampus (CA1, CA3 and DG).

Key findings

The administration of TMP reduced the seizure score and percentage of kindled animals dose-dependently. Furthermore, TMP significantly improved the behavioural parameters measured in the predictive models of depression but not in the anxiety and cognitive performances of the animals. The oxidative-nitrosative stress, excitotoxicity, neuroinflammation and histological alterations in the brain induced by PTZ were significantly mitigated by administering the TMP high dose of 60 mg/kg.

Conclusion

In conclusion, the TMP attenuated the depression behaviour in the PTZ-induced kindled rats, and reduced the oxidative-nitrosative stress, excitotoxicity, neuroinflammation and histological alterations of the brain.
A sequential Monte Carlo approach to estimate a time-varying reproduction number in infectious disease models: the Covid-19 case
Authors: Storvik Geir , Diz-Lois Palomares Alfonso , Engebretsen Solveig , Rø Gunnar Øyvind Isaksson , Engø-Monsen Kenth , Kristoffersen Anja Bråthen , de Blasio Birgitte Freiesleben , Frigessi Arnoldo
Published: April 2023

The Covid-19 pandemic has required most countries to implement complex sequences of non-pharmaceutical interventions, with the aim of controlling the transmission of the virus in the population. To be able to take rapid decisions, a detailed understanding of the current situation is necessary. Estimates of time-varying, instantaneous reproduction numbers represent a way to quantify the viral transmission in real time. They are often defined through a mathematical compartmental model of the epidemic, like a stochastic SEIR model, whose parameters must be estimated from multiple time series of epidemiological data. Because of very high dimensional parameter spaces (partly due to the stochasticity in the spread models) and incomplete and delayed data, inference is very challenging. We propose a state-space formalization of the model and a sequential Monte Carlo approach which allow to estimate a daily-varying reproduction number for the Covid-19 epidemic in Norway with sufficient precision, on the basis of daily hospitalization and positive test incidences. The method was in regular use in Norway during the pandemics and appears to be a powerful instrument for epidemic monitoring and management.
Finding a Provider
Authors: Evans Dwight L. , Benton Tami D. , Ellison Katherine
Published: April 2023

This chapter considers the struggles of finding a proper provider while seeking care for children with bipolar disorder. It acknowledges the scarcity of mental health experts in the United States. Most of the hardships in acquiring mental health care disproportionately affect people of color, families with low incomes, and the lingering stigma within their communities and the medical system. The chapter provides tips for coping with emergencies, such as aiming for a gold standard and checking out national referral services. It also notes psychiatrists and mental health counselors as some of the different kinds of professionals that provide mental health services. On the other hand, the services of digital care and telepsychiatry skyrocketed following the COVID-19 pandemic.
If Your Adolescent Has Depression
Authors: Evans Dwight L. , Rynn Moira A. , Ellison Katherine
Published: April 2023

If Your Adolescent Has Depression: An Essential Resource for Parents provides a definitive guide for parents and other adults to understand and get effective help for adolescents with depression. Millions of parents have been caught off-guard by a nonnegotiable signal that they need to step in to mitigate their children’s depression. Thus, the most current scientific expertise had been combined with no-nonsense and hands-on advice from parents who have experienced a mood disorder in their children. Moreover, the scientific expertise includes the newest treatments, medications, and the latest research findings regarding depression. The book also covers the information and tools parents need to aid adolescents to achieve the best possible outcome in coping with their condition.
Introduction
Authors: Evans Dwight L. , Rynn Moira A. , Ellison Katherine
Published: April 2023

This introductory chapter clarifies that depression is more than being moody despite the expected hormonal changes in an adolescent. It assures that depression is a treatable illness with the help of compassionate and effective help from professionals. In recent times, young people have many good reasons to be moody aside from their changing biochemistry. The recent increase in depression and anxiety cases showed a correlation to climate change, income inequality, increasing job competition, and social media. The chapter also notes depression as one of the most common mental illnesses worldwide. Leading US health groups, like the American Academy of Pediatrics, have rung the bell for a national emergency in youth mental health. The chapter explains the decreasing stigma around mental health illnesses.
Treatment
Authors: Evans Dwight L. , Rynn Moira A. , Ellison Katherine
Published: April 2023

This chapter focuses on psychotherapy, which is known to be one of the most promising treatments for depression. Even though psychotherapy requires a major commitment of time, energy, and other resources, the practice can greatly improve a child’s outlook and teach them coping skills that may last a lifetime. The treatment also helps families manage the conflict that often accompanies the illness. According to imaging research, psychotherapy targets the psychological, social, behavioral, and environmental aspects and physically changes the brain similar to medication. The chapter highlights the significance of parental health and self-care. It expounds on how cognitive-behavioral therapy could help change a patient’s thinking patterns.
Helping at Home
Authors: Evans Dwight L. , Rynn Moira A. , Ellison Katherine
Published: April 2023

This chapter looks into the risk factors and protective factors of several potential contributors to depression. It shows how the relationship, behavior, and environment of a home could enormously influence the child’s mental health. Even though medication and psychotherapy can work wonders in treating depression, the child will still need a variety of environmental supports and healthy habits to ward off harmful moods. Making progress with health habits, sleep, predictability at home, and strength can help people through depression. The chapter explains the importance of communication and availability, especially when depression often causes problems with thinking and understanding. Be aware of your parenting style. It will be most helpful to provide a nurturing, warm, and flexible approach with appropriate limits.
Sex, Drugs, and Social Media
Authors: Evans Dwight L. , Rynn Moira A. , Ellison Katherine
Published: April 2023

This chapter shares the challenges brought by sex, drugs, and social media in supporting children. It notes that contemporary moms and dads know that mental illness is real, and adults have more emotional work when raising children. Parents of children with depression are advised to be extra-vigilant about the dangers of online content, especially when children tend to depend on the internet for schoolwork, socializing, and establishing their autonomy and identity. The chapter highlights the importance of communication and vigilance with children. It explains how sex, drugs, and social media could turn into a unhealthy coping mechanism to manage symptoms of depression and anxiety.
Surviving School
Authors: Evans Dwight L. , Rynn Moira A. , Ellison Katherine
Published: April 2023

This chapter cites school as a critically important environment in a child’s life. It acknowledges the constant and powerful potential impacts of school on the mental health of a child with depression. Heightened stress, after all, can be especially hard on people struggling with mental illness. Bullying, isolation, and not attending school are some of the major stumbling blocks a child can encounter through middle school and high school. The chapter offers a range of strategies to cope with other students’ cruelty to a depressed child and helping your child ability navigate academic and social obstacles. In addition to receiving treatment with medication, psychotherapy, and school based approached you may still need to consider the option of changing schools, homeschooling, and adding additional supports.
Getting Better Faster
Authors: Falk Avital , Bennett Shannon , Rozenman Michelle , Mohatt Justin , Bergman Lindsey
Published: April 2023

Getting Better Faster: A Clinician’s Guide to Intensive Treatment for Youth with OCD provides a full guide for clinicians who are creating, running, or planning intensive treatment programs for youth with obsessive compulsive disorder (OCD). It offers practical guidance on how to administer evidence-based treatments for OCD, including cognitive behavior therapy (CBT), exposure and response prevention (ERP), medication management, parent guidance, and family work in an intensive format to target moderate-to-severe OCD over a brief period of time. There is a rapidly growing interest in brief intensive treatment modalities in both clinical and research settings. Intensive treatment for OCD condenses evidence-based interventions into more patient contact hours per week than standard weekly therapy and is widely supported as an efficient, effective, and desirable treatment option. Despite broad interest in developing concentrated treatment programs for OCD, practitioners face several challenges when trying to launch and maintain these programs. This book covers the topics of import for clinicians, researchers, and administrators, across different types of institutions and care settings, who want to build an intensive treatment program into their clinical practice. This guidebook reviews the benefits of intensive treatment, when and for whom to use this model, and how to identify and overcome challenges and barriers to implementation. It provides options for program structure, session outlines, treatment handouts, and resources for clinicians to use with patients and families.