bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Validated Method for Separation and Determination of Codeine Phosphate Hemihydrate Impurities in Bilayer Tablet Dosage Form of Naproxen Sodium and Codeine Phosphate by Using UHPLC
Authors: Koparan Arzu , Gökalp Mine 
Published: May 2020

Background:
Apranax Plus® is a new bilayer tablet dosage form, which combines two active pharmaceutical
ingredients: naproxen sodium and codeine phosphate.

Objective:
The purpose of this work was to develop an ultra-high-performance liquid chromatography (UHPLC) method
for the separation and determination of codeine phosphate hemihydrate impurities in a bilayer tablet dosage form.

Methods:
The separation and determination of codeine phosphate hemihydrate and its impurities,
methylcodeine, morphine, codeine dimer, 10-hydroxycodeine, 14-hydroxycodeine, thebaine and codeinone
were achieved by using reversed-phase liquid chromatography with TUV (Tunable UV Detector)
and PDA (Photodiode Array Detector) detection by UHPLC. The new proposed method utilized by
the Waters Acquity UHPLC® TUV and PDA systems using a UHPLC column Waters Acquity, BEH,
C18, 2.1x100 mm, 1.7 μm particle size with a mixture of component A and acetonitrile in a gradient
mode at a flow rate of 0.3mL/min, at 25°C with a load of 5μL. The detection for all eluted compounds
was carried out at 245nm.

Results:
The codeine phosphate hemihydrate and peaks of its impurities were adequately obtained, thus proving the
stability-indicating power of the method. The developed method was validated as per the ICH guidelines with respect to
parameters such as precision, accuracy, linearity, limit of detection (LOD), limit of quantification (LOQ) and robustness.

Conclusion:
It was verified as being adequate for all the mentioned impurities of codeine phosphate
hemihydrate. The described method was found to be useful for routine purity testing and was also found suitable for the
analysis of the stability samples of the drug product.
Viewing Trends and Users’ Perceptions of the Effect of Sleep-Aiding Music on YouTube: Quantification and Thematic Content Analysis
Authors: Eke Ransome , Li Tong , Bond Kiersten , Ho Arlene , Graves Lisa 
Published: May 2020

Background
Sleep plays an essential role in the psychological and physiological functioning of humans. A report from the Centers for Disease Control and Prevention (CDC) found that sleep duration was significantly reduced among US adults in 2012 compared to 1985. Studies have described a significant association between listening to soothing music and an improvement in sleep quality and sleep duration. YouTube is a platform where users can access sleep-aiding music videos. No literature exists pertaining to the use of sleep-aiding music on YouTube.

Objective
This study aimed to examine the patterns of viewing sleep-aiding music videos on YouTube. We also performed a content analysis of the comments left on sleep-aiding music video posts, to describe the perception of users regarding the effects of these music videos on their sleep quality.

Methods
We searched for sleep-aiding music videos published on YouTube between January 1, 2012, and December 31, 2017. We sorted videos by view number (highest to lowest) and used a targeted sampling approach to select eligible videos for qualitative content analysis. To perform the content analysis, we imported comments into a mixed-method analytical software. We summarized variables including total views, likes, dislikes, play duration, and age of published music videos. All descriptive statistics were completed with SAS statistical software.

Results
We found a total of 238 sleep-aiding music videos on YouTube that met the inclusion criteria. The total view count was 1,467,747,018 and the total playtime was 84,252 minutes. The median play length was 186 minutes (IQR 122 to 480 minutes) and the like to dislike ratio was approximately 9 to 1. In total, 135 (56.7%) videos had over 1 million views, and 124 (52.1%) of the published sleep-aiding music videos had stayed active for 1 to 2 years. Overall, 4023 comments were extracted from 20 selected sleep-aiding music videos. Five overarching themes emerged in the reviewed comments, including viewers experiencing a sleep problem, perspective on the positive impact of the sleep-aiding music videos, no effect of the sleep-aiding music videos, time to initiation of sleep or sleep duration, and location of viewers. The overall κ statistic for the codes was 0.87 (range 0.85-0.96).

Conclusions
This is the first study to examine the patterns of viewing sleep-aiding music videos on YouTube. We observed a substantial increase in the number of people using sleep-aiding music videos, with a wide variation in viewer location. This study supports the hypothesis that listening to soothing music has a positive impact on sleep habits.
Patients’ and Health Care Professionals’ Perceptions of the Potential of Using the Digital Diabetes Questionnaire to Prepare for Diabetes Care Meetings: Qualitative Focus Group Interview Study
Authors: Eeg-Olofsson Katarina , Johansson Unn-Britt , Linder Ebba , Leksell Janeth 
Published: May 2020

Background
In effective diabetes management, it is important that providers and health care systems prioritize the delivery of patient-centered care and that they are respectful of and responsive to individual patient preferences and barriers.

Objective
The objective of the study was to conduct focus group interviews to capture patients’ and health care professionals’ perceptions and attitudes regarding digital technology and to explore how the digital Diabetes Questionnaire can be used to support patient participation in diabetes care, as a basis for an implementation study.

Methods
A qualitative study was conducted with six focus group discussions with diabetes specialist nurses and medical doctors (n=29) and four focus group discussions with individuals with diabetes (n=23). A semistructured focus group interview guide was developed, including probing questions. The data were transcribed verbatim, and qualitative content analysis was performed using an inductive approach.

Results
Two main categories were revealed by the qualitative analysis: perceptions of digital technology and the digital questionnaire in diabetes management and care and perceptions of participation in diabetes care. An overarching theme that emerged from the focus group interviews was patients’ and professionals’ involvement in diabetes care using digital tools.

Conclusions
The analysis identified important factors to consider when introducing the digital Diabetes Questionnaire in clinical use. Both professionals and patients need support and training in the practical implementation of the digital questionnaire, as well as the opportunity to provide feedback on the questionnaire answers.
Evaluation of Volume of News Reporting and Opioid-Related Deaths in the United States: Comparative Analysis Study of Geographic and Socioeconomic Differences
Authors: Hswen Yulin , Zhang Amanda , Freifeld Clark , Brownstein John S 
Published: May 2020

Background
News media coverage is a powerful influence on public attitude and government action. The digitization of news media covering the current opioid epidemic has changed the landscape of coverage and may have implications for how to effectively respond to the opioid crisis.

Objective
This study aims to characterize the relationship between volume of online opioid news reporting and opioid-related deaths in the United States and how these measures differ across geographic and socioeconomic county-level factors.

Methods
Online news reports from February 2018 to April 2019 on opioid-related events in the United States were extracted from Google News. News data were aggregated at the county level and compared against opioid-related death counts. Ordinary least squares regression was used to model opioid-related death rate and opioid news coverage with the inclusion of socioeconomic and geographic explanatory variables.

Results
A total of 35,758 relevant news reports were collected representing 1789 counties. Regression analysis revealed that opioid-related death rate was positively associated with news reporting. However, opioid-related death rate and news reporting volume showed opposite correlations with educational attainment and rurality. When controlling for variation in death rate, counties in the Northeast were overrepresented by news coverage.

Conclusions
Our results suggest that regional variation in the volume of opioid-related news reporting does not reflect regional variation in opioid-related death rate. Differences in the amount of media attention may influence perceptions of the severity of opioid epidemic. Future studies should investigate the influence of media reporting on public support and action on opioid issues.
Effects of Incentives on Adherence to a Web-Based Intervention Promoting Physical Activity: Naturalistic Study
Authors: Wurst Ramona , Maliezefski Anja , Ramsenthaler Christina , Brame Judith , Fuchs Reinhard 
Published: May 2020

Background
Despite many advantages of web-based health behavior interventions such as wide accessibility or low costs, these interventions are often accompanied by high attrition rates, particularly in usage under real-life conditions. It would therefore be helpful to implement strategies such as the use of financial incentives to motivate program participation and increase adherence.

Objective
This naturalistic study examined real-life usage data of a 12-week web-based physical activity (PA) intervention (Fitness Coach) among insurants who participated in an additional incentive program (incentive group) and those who did not (nonincentive group). Users in the incentive group had the perspective of receiving €30 (about US $33) cash back at the end of the intervention.

Methods
Registration and real-life usage data as part of routine data management and evaluation of the Fitness Coach were analyzed between September 2016 and June 2018. Depending on the duration of use and the weekly recording of tasks, 4 adherence groups (low, occasional, strong, and complete adherence) were defined. Demographic characteristics were collected by a self-reported questionnaire at registration. We analyzed baseline predictors and moderators of complete adherence such as participation in the program, age, gender, and BMI using binary logistic regressions.

Results
A total of 18,613 eligible persons registered for the intervention. Of these, 15,482 users chose to participate in the incentive program (incentive group): mean age 42.4 (SD 14.4) years, mean BMI 24.5 (SD 4.0) kg/m2, median (IQR) BMI 23.8 (21.7-26.4) kg/m2; 65.12% (10,082/15,482) female; and 3131 users decided not to use the incentive program (nonincentive group): mean age 40.7 (SD 13.4) years, mean BMI 26.2 (SD 5.0) kg/m2, median BMI 25.3 (IQR 22.6-28.7) kg/m2; 72.18% (2260/3131) female. At the end of the intervention, participants in the incentive program group showed 4.8 times higher complete adherence rates than those in the nonincentive program group (39.2% vs 8.1%), also yielding significantly higher odds to complete the intervention (odds ratio [OR] 12.638) for the incentive program group. Gender significantly moderated the effect with men in the incentive group showing higher odds to be completely adherent than women overall and men in the nonincentive group (OR 1.761). Furthermore, older age and male gender were significant predictors of complete adherence for all participants, whereas BMI did not predict intervention completion.

Conclusions
This is the first naturalistic study in the field of web-based PA interventions that shows the potential of even small financial incentives to increase program adherence. Male users, in particular, seem to be strongly motivated by incentives to complete the intervention. Based on these findings, health care providers can use differentiated incentive systems to increase regular participation in web-based PA interventions.
Reinforcement Learning for Clinical Decision Support in Critical Care: Comprehensive Review
Authors: Liu Siqi , See Kay Choong , Ngiam Kee Yuan , Celi Leo Anthony , Sun Xingzhi , Feng Mengling 
Published: May 2020

Background
Decision support systems based on reinforcement learning (RL) have been implemented to facilitate the delivery of personalized care. This paper aimed to provide a comprehensive review of RL applications in the critical care setting.

Objective
This review aimed to survey the literature on RL applications for clinical decision support in critical care and to provide insight into the challenges of applying various RL models.

Methods
We performed an extensive search of the following databases: PubMed, Google Scholar, Institute of Electrical and Electronics Engineers (IEEE), ScienceDirect, Web of Science, Medical Literature Analysis and Retrieval System Online (MEDLINE), and Excerpta Medica Database (EMBASE). Studies published over the past 10 years (2010-2019) that have applied RL for critical care were included.

Results
We included 21 papers and found that RL has been used to optimize the choice of medications, drug dosing, and timing of interventions and to target personalized laboratory values. We further compared and contrasted the design of the RL models and the evaluation metrics for each application.

Conclusions
RL has great potential for enhancing decision making in critical care. Challenges regarding RL system design, evaluation metrics, and model choice exist. More importantly, further work is required to validate RL in authentic clinical environments.
SHELF-LIFE ASSESSMENT OF DANTASHODHANA PASTE (A POLYHERBAL TOOTHPASTE): A PRELIMINARY STUDY
Authors: MAKWANA DHARA , R GALIB , DAVE PARTH PRAKASHBHAI , RAJAGOPALA MANJUSHA , PRAJAPATI PRADEEP KUMAR 
Published: May 2020

Objective: Shelf life is the period during which the potency (Virya) of a drug remains unaffected due to environmental factors or from microbial contamination. Considering the growing popularity of Ayurveda products, it becomes important to maintain the quality of all such products. Shelf life is one of the essential components under quality and needs to be evaluated for all products. Dantashodhana paste (DP) is a polyherbal toothpaste containing Vyosha (Zingiber officinale Roxb., Piper nigrum Linn., and Piper longum Linn.), Trijata (Cinnamomum zeylanicum Blume., Elettaria cardamomum Maton., Cinnamomum tamala (Buch.-Ham.) T.Nees and Eberm.), Tejovati (Zanthoxylum armatum DC.), Saindhava (rock salt), and other excipients.
Methods: DP was prepared with the following standard guidelines. The samples were subjected to accelerated stability study by maintaining temperature and humidity 40±2°C and 75±5%, respectively. Relevant analytical parameters were analyzed at an interval of 0, 1, 3, and 6 months to check the degradation levels in the formulation.
Results: DP was found to be free from microbial contamination. Heavy metals were within the prescribed limits for toothpaste complying the official standards. There were insignificant changes in physicochemical profiles at different intervals. On extrapolation of the observations, the shelf life of DP was found to be 12.16 years.
Conclusion: Shelf life of DP is found to be much longer than the standards specified in the D and C act. This prolonged shelf life may be contributed to care taken during drug preparation, storage, and properties of herbal drugs used in the formulation.
MULTIDRUG-RESISTANCE PATTERNS AND DETECTION OF PstS GENE IN CLINICAL ISOLATES OF PSEUDOMONAS AERUGINOSA FROM NSUKKA, SOUTHEAST NIGERIA
Authors: C AGBO MARTINA , M EZEONU IFEOMA , C IKE ANTHONY , C UGWU CELESTINA 
Published: May 2020

Objective: This study was aimed to determine the antibiotic resistance patterns of clinical Pseudomonas aeruginosa isolates and to detect the presence of PstS gene.
Methods: One hundred and ninety-two clinical isolates of P. aeruginosa were characterized using polymerase chain reaction (PCR) and 16S rDNA sequencing. Antibiotic resistance patterns were determined using the disk diffusion method, while the minimum inhibitory concentrations (MICs) of selected antibiotics against resistant isolates were determined by macro broth dilution and E-test strip methods. The resistant isolates were screened for the presence of PstS gene using PCR.
Results: Of 192 clinical isolates of P. aeruginosa, 136 (70.83%) were resistant to at least two antibiotics. Of these, 135 (99%) could be classified as multidrug-resistant P. aeruginosa (MDR-PA), 63 (46%) were extensively drug-resistant (XDR-PA), while 38 (28%) were pandrug-resistant (PDR-PA). The isolates exhibited high level of resistance to cefotaxime and ticarcillin, and low levels of resistance to meropenem and imipenem. The MIC values for meropenem against the resistant isolates were generally <32 mg/L, while the values for other antibiotics ranged from 32 to >128 mg/L. Multiple antibiotic resistance indexes of the MDR-PA ranged from 0.27 to 0.91 and the most prevalent pattern of resistance was PiperacillinR – TicarcillinR – Piperacillin/TazobactamR – CefotaximeR – CeftazidimeR – GentamicnR – TobramycinR– CiprofloxacinR. About 50% of the resistant isolates possessed the PstS gene.
Conclusions: The results confirmed the presence of XDR, PDRPA, and PstS gene in P. aeruginosa strains. There is an urgent need for healthcare practitioners to address the problem of multidrug resistance, by implementing a more rational and appropriate use of antibiotics.
A CASE STUDY ON CLINICAL PHARMACIST INTERVENTIONS IN THE MANAGEMENT OF DIABETES COMPLICATED CORONARY ARTERY DISEASE IN HEALTH-CARE PRACTICE
Authors: KUMAR A BHARATH , MS UMASHANKAR 
Published: May 2020

Objective: The objective of the study was to assess the clinical pharmacist interventions in the management of diabetes complicated coronary artery disease.
Methods: In the present study, a case history of a 55-year-old female was suffering from diabetes with coronary artery disease was taken. The case was collected from the cardiology outpatient department in a tertiary care hospital. The case was analyzed from 1 to 3 months. The initial visit to the end of final visit her laboratory parameters was examined at the laboratory.
Results: The test report of electrocardiogram revealed sinus rhythm. The patient was advised for an echocardiogram which confirmed coronary artery disease. The patient was subjected to a coronary angiogram, which revealed the presence of double-vessel disease. Her ankle-brachial index study test revealed peripheral artery disease. The patient was diagnosed with coronary artery disease, and she was prescribed with regular medications. The patient was monitored for 1-week duration and prescribed with coronary artery disease medications to normalize the condition. The patient was improved with the treatment and advised for regular follow-ups.
Conclusion: The study concludes that there was an imperative need for regular health screening by the physician associated clinical pharmacist care services with an effective treatment modality that can reduce the coronary artery disease incidences in this patient.
IN VITRO EVALUATION OF ENZYMIC ANTIOXIDANTS AND FREE RADICAL SCAVENGING ACTIVITY IN THE ETHANOLIC EXTRACT OF CRESCENTIA CUJETE LEAVES
Authors: P ANITHA , TH NAZEEMA 
Published: May 2020

Objectives: This study aims to evaluate the enzymic antioxidants and free radical scavenging present in the ethanolic leaf extracts of Crescentia cujete.
Methods: Enzymic antioxidants such as superoxide dismutase (SOD), catalase (CAT), glutathione reductase, glutathione peroxidase, and glutathione S-transferase (GST) were estimated by standard methods. Free radical scavenging potential was evaluated by diphenylpicrylhydrazyl (DPPH), nitric oxide, and hydroxyl radical methods using an ethanolic extract of C. cujete leaf.
Results: The leaf extract of C. cujete showed the maximum activity of CAT, SOD, GST, glutathione reductase, and peroxidase activity. CAT activity was formed to be highest in the ethanolic extract of C. cujete leaf. DPPH radical scavenging activity was reported as 38.5 μg/ml, nitric oxide was found to be 200.77 μg/ml, and hydroxyl radical scavenging exhibited 108.42 μg/ml normalized with ascorbic acid.
Conclusion: From the results, it has concluded that the ethanol extract of the C. cujete leaf has a prospective source of natural antioxidant that would be a great significance as therapeutic agents in preventing or slowing the progress of reactive oxygen species and related oxidative stress-related degenerative diseases.
PRESCRIBING PATTERN AND APPROPRIATENESS OF PRESCRIPTION AMONG ELDERLY PATIENTS IN A TERTIARY CARE HOSPITAL OF WESTERN NEPAL – A PROSPECTIVE CROSSSECTIONAL STUDY
Authors: GIRI SAGARANANDA , MUHAMMAD KHAN GULAM 
Published: May 2020

Objective: The current study aims to evaluate prescribing pattern and potentially inappropriate medicine (PIM) among elderly patients in a tertiary care hospital of western Nepal.
Methods: A prospective cross-sectional study was conducted in the outpatient department of Manipal Teaching Hospital of Western Nepal. The World Health Organization prescribing indicators and Beers’ 2015 updated criteria were assessed to analyze the result.
Results: The mean±standard deviation of the age was 73.47±6.42 years and the majority of patients were in the age group 65–74 (58.81%). Male preponderance (male: female=1.20:1) was found. The value of prescribing indicator includes the average number of drug per prescription (4.91), percentage of generic name prescription (3.40%), percentage of antimicrobials prescribed (19.40%), percentage of injections prescribed (2.70%), and percentage of the drug from essential drug list of Nepal (42.22%). At least one PIM was prescribed to 87 (21.6%) patients. Non-cyclooxygenase-selective nonsteroidal anti-inflammatory drugs (44%) and anticholinergics (18%) were the most frequently prescribed PIMs.
Conclusions: Polypharmacy, PIMs, and potential drug-drug interaction were prevalent in this study. It is recommended that all the doctors, pharmacists, other concerned health-care professionals, patients, policymakers, and all other stakeholders must be aware of these situations and a multidisciplinary approach must be developed for the promotion of rational use of drugs.
CO-TRIMOXAZOLE PREVENTIVE THERAPY REDUCES ACTIVE PULMONARY TUBERCULOSIS RISK IN PEOPLE LIVING WITH HIV/AIDS ON ANTIRETROVIRAL AT WANGAYA HOSPITAL IN DENPASAR, BALI, INDONESIA: A PROSPECTIVE COHORT STUDY
Authors: Suryana Ketut , Suharsono Hamong , Sindhughosa Dwijo Anargha 
Published: May 2020

Objective: To evaluate whether co-trimoxazole preventive therapy (CPT) and other contributing factors, among people living with HIV/AIDS (PLWHA) on antiretroviral (ARV) are effective to reduce active pulmonary tuberculosis (APT) at Wangaya Hospital, Denpasar, Bali, Indonesia.
Methodology: A prospective cohort study was conducted to evaluate the use of CPT in reducing APT. In this study, 403 PLWHA on ARV 151 participants accepted CPT as the first group and 252 PLWHA refused CPT as the second group. Eight participants among the first group and 48 participants among the second group were confirmed APT. Revisits were scheduled every a month to replenish pills and to confirm APT. The CPT effectiveness, sociodemography and laboratory, and reducing APT risk after prospective cohort entry were analyzed using Chi-square with significant p<0.05. Statistical software package SPSS 15.0 was used for statistical analysis.
Results: Two hundred fifty-one (62.2%) of the participants were males and 152 (37.8%) females. Eight (2.0%) of the first group were confirmed APT and 48 (12.0%) of the second group were confirmed APT (p=0.004). In bivariate analysis (Chi-square), we found that sex (p=0.019), smoking (p=0.000), alcohol consumption (p=0.000), previous history of tuberculosis (TB) (p=0.000), and CD4 cell counts (<69 cell/μL) (p=0.002) were significant APT risk factors. There was significantly less APT risk among the participants who accepted CPT compared with participants refused CPT (p=0.002).
Conclusions: This study found that CPT was significantly associated with reduce of APT risk in PLWHA. Furthermore, there were significantly added the preventive effect of CPT; sex, smoking, alcohol consumption, previous history of TB, and CD4 cell counts.