bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population pharmacokinetic model of blood THC and its metabolites in chronic and occasional cannabis users and relationship with on‐site oral fluid testing
Authors: Alvarez Jean Claude , Hartley Sarah , Etting Isabelle , Ribot Mégane , Derridj‐Ait‐Younes Nawal , Verstuyft Céline , Larabi Islam‐Amine , Simon Nicolas 
Published: January 2021

AimsTo develop a population pharmacokinetic (PP) model of delta‐9‐tetrahydrocannabinol (THC) and its metabolites in blood and to determine the relationship between blood THC pharmacokinetics and results of on‐site oral fluid (OF) testing in chronic (CC) and occasional (OC) cannabis users.MethodsFifteen CC (1–2 joints/day) and 15 OC (1–2 joints/week) aged 18–34 years were included, genotyped for their CYP2C9 polymorphisms. Twelve measurements of blood THC, 11‐OH‐THC and THC‐COOH were carried out during the 24‐hour period after controlled cross‐over random inhalation of placebo, 10 mg or 30 mg of THC. OF tests (DrugWipe® 5S) were performed up to 6 hours and then stopped after two successive negative results. The blood concentrations and their relationship to OF testing results were analysed using a PP approach with NONMEM® and R.ResultsA three‐compartment model described the pharmacokinetics of THC, with zero‐order absorption, and a two‐compartment model the metabolites. The fraction of THC converted to 11‐OH‐THC was 0.27 and the fraction of 11‐OH‐THC to THC‐COOH was 0.86. Smoking 30 mg of THC decreased the THC bioavailability to 0.68 compared to 10 mg. CC showed a 2.41 greater bioavailability than OC, leading to higher Cmax and AUC for the three compounds for the same dose. The best model describing the probability of a positive OF test included THC blood concentration and the group as covariate: for a similar THC blood concentration, a CC was less likely to be positive than an OC.ConclusionOC are more likely to screen positive than CC for a similar blood concentration.
The effect of activated charcoal on drug exposure following intravenous administration: A meta‐analysis
Authors: Skov Kenneth , Graudal Niels A. , Jürgens Gesche 
Published: January 2021

AbstractActivated charcoal both reduces primary drug absorption and enhances drug elimination. However, the two mechanisms of action overlap and are indistinguishable from each other. In order to estimate the extend of enhanced elimination, we summarized the effect of activated charcoal on intravenously administered drugs, where reduced drug exposure can be attributed to enhanced elimination. We performed a meta‐analysis of randomized controlled studies evaluating the effect of orally administered activated charcoal on the systemic exposure of intravenously administered drugs. We searched the bibliographic databases PubMed, Embase and Cochrane. Meta‐regression analyses of selected physiochemical drug properties on the effect sizes of activated charcoal were performed. All but one of 21 included studies used multiple‐dose activated charcoal (MDAC). MDAC reduced the median half‐life of the intravenously administered study drugs by 45.7% (interquartile range: 15.3%‐51.3%) and area under the concentration time curve by 47.0% (interquartile range: 36.4%‐50.2%). MDAC significantly improved drug elimination across nine different intravenously administered drugs, but we were unable to identify factors allowing extrapolation to other drugs. The results offer a possible and plausible rationale for the previously observed effects of single‐dose activated charcoal beyond the timeframe where ingested drug is present in the gastro‐intestinal tract.
Pain and anxiety during vasectomies while distracting patients with video glasses or virtual reality glasses
Authors: Dings Sam J.M. , van Stralen Karlijn J. , Struben Veerle M.D. , Noordzij Marinus Arjen 
Published: January 2021

ObjectiveTo determine whether it is possible to reduce the amount of pain and anxiety experienced during a vasectomy by use of two‐dimensional (2D) video glasses or virtual reality (VR) glasses during the vasectomy.Patients and MethodsA non‐randomised controlled trial was performed between October 2017 and March 2018. A total of 176 patients were planned for a vasectomy in an outpatient setting and 141 of these patients were divided sequentially into three groups: Control, 2D video glasses and VR glasses. Follow‐up lasted 7 days. One patient was lost to follow‐up. The main outcomes were pain (visual analogue scale [VAS] score 0–10) and anxiety ((VAS score 0–10), and State‐Trait Anxiety Inventory for Adults [STAI‐AD] score 20–80) during the vasectomy. Data were compared using analysis of variance or chi‐square measurements.ResultsNo significant differences in pain were found (VAS score of 2 in all groups). The odds ratio (OR) and (95% confidence interval [CI]) in the 2D video glasses group was 1.15 (0.92–1.48) and in the VR group was 0.98 (0.76–1.26). Patients in the VR group experienced significantly more anxiety during the procedure (OR 1.40, 95% CI 1.07–1.85). Also, patients without prior hospitalisation reported significantly more pain than patients with one or more hospitalisations (OR 1.35, 95% CI 1.11–1.65).ConclusionsThe VR and 2D video glasses did not reduce pain or stress during the vasectomy. In the VR group, the anxiety levels during the procedure were even higher.
Novel quantitative structure–activity relationship model to predict activities of natural products against COVID‐19
Authors: Si Yaru , Xu Xinyue , Hu Yingfeng , Si Hongzong , Zhai Honglin 
Published: January 2021

AbstractCurrently, COVID‐19 is spreading in a large scale while no efficient vaccine has been produced. A high‐effective drug for COVID‐19 is very necessary now. We established a satisfied quantitative structure–activity relationship model by gene expression programming to predict the IC50 value of natural compounds. A total of 27 natural products were optimized by heuristic method in CODESSA program to build a liner model. Based on it, only two descriptors were selected and utilized to build a nonlinear model in gene expression programming. The square of correlation coefficient and s2 of heuristic method were 0.80 and 0.10, respectively. In gene expression programming, the square of correlation coefficient and mean square error for training set were 0.91 and 0.04. The square of correlation coefficient and mean square error for test set are 0.86 and 0.1. This nonlinear model has stronger predictive ability to develop the targeted drugs of COVID‐19.
Blood eosinophils associate with reduced lung function growth in adolescent asthmatics
Authors: Koefoed Hans Jacob L. , Gehring Ulrike , Vonk Judith M. , Koppelman Gerard H. 
Published: January 2021

AbstractBackground and ObjectiveSome children with asthma have low lung growth, putting them at increased risk for COPD later in life. However, it is currently not clear who will experience this adverse growth pattern. We therefore investigated the predictive role of blood eosinophils as a type 2 inflammation marker in lung growth, focusing on the presence and severity of asthma.MethodsWe investigated blood eosinophils and lung function growth (percentage of predicted values) using linear mixed models in children and adolescents from two longitudinal cohorts. One cohort was hospital‐based and consisted of asthmatic children at their first outpatient clinic visit after referral by the general practitioner (n = 133, mean age 9.8), while the second was a general population‐based birth cohort (PIAMA, asthma n = 52 and non‐asthma n = 433, mean age 8.1). The hospital‐based cohort had not been treated with inhaled corticosteroids (ICS) before referral.ResultsSubjects in the hospital‐based asthma cohort had more severe asthma compared with the asthmatic subjects in the population‐based cohort, defined by lower lung function levels and a higher prevalence of bronchial hyper‐responsiveness. In the asthma cohort, higher blood eosinophil numbers were associated with less growth in FEV1 (estimated change in lung function per 1 unit increase in ln blood eosinophils (B): −0.66%/year (95% confidence interval (CI): −1.11 to −0.20, p < .01)) and FVC (B: −0.40%/year (95% CI: −0.75 to −0.05), p = .025)) during follow‐up in adolescence (min 7, max 17 years). These associations were not observed in the general population‐based birth cohort, regardless of asthma status during follow‐up (age 8–16).Conclusions and Clinical RelevanceBlood eosinophil counts in children with asthma not treated with ICS at referral were predictive of lower growth in FEV1 and FVC during follow‐up in adolescence. Our findings indicate that this association is dependent on the degree of asthma severity. Future studies should address whether anti‐eosinophilic treatments preserve lung function growth in children with asthma.
Thyroid‐stimulating hormone levels and incident depression: Results from the ELSA‐Brasil study
Authors: Varella Ana C. , Benseñor Isabela M. , Janovsky Carolina C.P.S. , Goulart Alessandra C. , Birck Marina G. , Santos Itamar S. , Brunoni Andre R. , Lotufo Paulo A. 
Published: January 2021

AbstractObjectiveThis study aimed to prospectively evaluate whether TSH levels at baseline were associated with incident depression after four years of follow‐up in a cohort of middle‐aged adults, the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil).MethodsTSH and free‐thyroxine (FT4) levels were evaluated at baseline. Depression diagnoses were performed using the Clinical Interview Schedule—Revised (CIS‐R) at baseline and after a 4‐year follow‐up. Poisson regression models (95% Confidence Intervals) were built to evaluate the association between TSH quintiles at baseline and incident depression. All analyses were stratified by sex. Models were presented crude, adjusted for age and sex; and further adjusted for race, education, BMI, smoking, alcohol consumption, use of antidepressants/benzodiazepines, kidney function and comorbidities.ResultsMean age was 51.5 years, and 51.2% were women. Overall, low TSH levels (1st quintile) were associated with incident depression (adjusted RR = 1.36, 95% CI 1.02–1.81), remaining significant for women (adjusted RR = 1.64, 95% CI 1.15–2.33), but not for men. The same results were found when restricting analysis to euthyroid participants (adjusted RR = 1.46, 95% CI 1.08–1.99), also significant for women only (adjusted RR = 1.63, 95% CI 1.12–2.38).ConclusionsOur results showed that low TSH levels were positively associated with incident depression, particularly among women. Similar results were found when restricting the analysis to euthyroid participants. In contrast, high TSH levels were inversely associated with incident depression, also among women.
Sacral neuromodulation with the InterStim™ system for faecal incontinence: results from a prospective French multicentre observational study
Authors: Meurette Guillaume , Siproudhis Laurent , Leroi Anne‐Marie , Damon Henri , Urs Josef Keller David , Faucheron Jean‐Luc ,   French Faecal Registry Study Group
Published: January 2021

AbstractAimThe aim of this work was to evaluate the effectiveness, patient satisfaction and quality of life (QoL) and the safety of sacral neuromodulation (SNM) with the InterStimTM system for the treatment of faecal incontinence (FI) and establish whether results published predominantly by expert sites are generalisable.MethodThis is a prospective, multicentre, observational study that invited all French sites treating FI with the InterStim™ system to enrol subjects indicated for an SNM therapy evaluation. Data were collected at three follow‐up visits within 1 and 15 months. Therapeutic effectiveness was evaluated by the reduction in leakages per week and improvements over time in the ability to defer defaecation and QoL (as measured with the Faecal Incontinence Quality of Life score). Safety was assessed through reported adverse events.ResultsA total of 221 subjects with a mean age of 62.1 years were tested (184 women) and 178 received a permanent implant. For all implanted subjects with diary data at baseline and follow‐up, a reduction in leakage of more than 50% was observed in 80%, 76% and 83% at 1–3, 4–8 and 9–15 months, respectively. The mean number of leakage episodes and urgency improved significantly compared with the baseline (p < 0.0001). Subjects showed improvements in QoL and time to defer defaecation and were generally satisfied with their therapy. The main device‐related adverse event was the requirement to undertake reprogramming (in 52% of subjects with actions following an event). The rates of infection (in 6% of subjects) and surgical revision (in 10% of subjects) were in agreement with literature reports.ConclusionThis study confirms the clinical effectiveness, safety and positive effect of SNM on QoL as well as high patient satisfaction for the treatment of FI in real‐life.
Ileostomy for chronic constipation: a good idea or just asking for more trouble?
Authors: Davis George , Chapple Keith , Brown Steven R. 
Published: January 2021

AbstractAimA defunctioning stoma may be an option for a small group of patients with chronic constipation who have exhausted all forms of conservative management and remain symptomatic. We investigated this group in terms of stoma‐related complications and whether they regretted the intervention.MethodsPatients presenting to Sheffield Teaching Hospitals Pelvic Floor Unit over a 7‐year period with chronic constipation unresponsive to conservative management and who had undergone a loop ileostomy for management were interviewed using the decision regret scale. Details about subsequent stoma‐related surgery were recorded.ResultsThirty‐seven of 38 female patients identified (median age 49 years, range 24–86) completed the decision regret scale. Median follow‐up was 34 months (range 7–74). About half (49%) had no regret and a further 27% had minimal regret about the decision for a stoma. Fifty‐five per cent of patients had further operations related to the stoma, some undergoing up to five operations.ConclusionA small group of patients with intractable constipation may benefit from a loop ileostomy but are likely to need subsequent surgery to the stoma. Despite this most patients who have had a stoma do not regret the decision.
A network examination of risky behaviours in a state‐level and national epidemiological sample of high school students
Authors: Christian Caroline , Keshishian Ani C. , Levinson Cheri A. , Peiper Nicholas C. 
Published: January 2021

AbstractAimEngagement in risky behaviours, including substance use, disordered eating, suicidal behaviour, and peer victimization/violence, during adolescence is becoming increasingly prevalent. These risky behaviours are highly comorbid and associated with long‐term consequences for health, relationships, and socioeconomic status, representing an important public health concern. Past research has primarily investigated risky behaviours in adolescence using latent variable models, which are based on assumptions that may limit insight into the complex reality of these behaviours.MethodsThe current study uses network analysis to examine adolescent substance use, disordered eating, suicide risk, and peer victimization/violence in a national (N = 29 008) and state‐level (Kentucky; N = 3455) epidemiological dataset.We calculated central and bridge symptoms and compared network structure based on demographic factors (race, sex, grade) and sample (state vs. nation).ResultsThe most central symptoms were suicidal ideation and attempts, stimulant drug use, and prescription drug misuse. The most central bridge symptoms were depression, methamphetamine use, peer violence, and suicide attempts. There were no differences in network structure between samples or across demographic factors in the Kentucky sample. There were differences in network structure across sex and race in the national dataset.ConclusionsThese findings suggest stimulant use, suicidal ideation, depression, and peer violence may contribute to the high rates and co‐occurrence of risky behaviours in adolescence. Based on network theory, these symptoms may represent important targets for intervention. Due to network differences, special considerations may be necessary to adapt such interventions to meet the needs of students from different backgrounds.
Assessing dentist and dental student knowledge of and attitudes towards shared decision‐making in the United Kingdom
Authors: Sin Melissa , Butt Sara , Barber Sophy K. 
Published: January 2021

AbstractIntroductionShared decision‐making (SDM) is a partnership between healthcare professionals and patients when choosing care.AimTo measure knowledge of, and attitudes to, SDM amongst undergraduate dental students and dentists in the UK.Design and settingCross‐sectional online questionnaire for 4th and 5th year dental students and dentists in the UK.Materials and methodsThe questionnaire included attitudinal questions, knowledge of SDM relative to the evidence base and preferred approach to decision‐making. The questionnaire identified perceived learning needs and preferred method for SDM teaching for dentists and dental students. Respondents were invited to participate via social media, mailing lists and CPD courses.ResultsRespondents included 266 undergraduates and 130 dentists. SDM was defined by the people involved, components of the discussion, approach to decision‐making and expected outcome. Attitudes to SDM were generally positive although concerns were expressed about patients wanting professionals to make the decision, straying from the professionals’ preferred option and compatibility with clinical guidelines. Respondents reported a preference for decision‐making to involve patients, but this tended to be an informative rather than deliberative approach. Respondents were least sure of the evidence about the impact of SDM on adherence, choices and health outcomes, and the best approach to risk communication. Respondents from both groups reported an interest in learning more about SDM and its integration into clinical practice.ConclusionKnowledge of, and attitude to, SDM in UK dentists and dental undergraduates is generally positive; however, a demand for further SDM training was identified.
The periodontal senior case clinical challenge: Students’ opinions of a formative virtual assessment during the COVID‐19 emergency
Authors: Garcia M. Nathalia , Whitener Sara J. , Ghassemi Amirezza , Bitter Robert , Miley Douglas , Naylor Jeffrey , Drukteinis Saulius , Hildebolt Charles F. 
Published: January 2021

AbstractIntroductionDue to COVID‐19, innovative, virtual educational methods are being developed to provide students with learning experiences comparable to established clinical practices. Our objective was to produce the Periodontal Senior Case Clinical Challenge (PSCCC) that would provide fourth‐year students an alternative for senior case presentations and would be a formative assessment for which student opinions would be provided and analysed. The PSCCC would utilise an online, case‐based, written, clinical assessment and follow‐up, structured discussion to challenge students to demonstrate ability to apply didactic periodontal knowledge to patient‐based experiences. We hypothesised the PSCCC would provide effective learning and a formative assessment.Material and MethodsRelevant didactic resources were distributed to 48 students for independent review. The PSCCC was delivered in two sections, (1) a case‐based assessment via a virtual classroom with written student responses, and (2) oral discussions conducted via virtual meetings that were moderated and assessed by ten periodontists, with the collaboration of nine residents. A voluntary six‐statement survey was used to evaluate the students’ opinions of the PSCCC. The scores for 75% (36/48) of students who participated were evaluated for statistical and clinical importance.ResultsThe value of our PSCCC was supported by 91.7% (33/36) of the analyses (p < .0008).DiscussionThe PSCCC was a successful alternative pathway to assess students’ clinical and didactic integrated knowledge in periodontics. It provided a unified vision of treatment of the selected case, building on all aspects of the students’ periodontal education whilst allowing interaction in a simultaneous, three‐tiered educational approach, involving dental students, periodontal residents and faculty.ConclusionIn support of our hypothesis, for each of the 6 statements, ≥94.44% (34/36) of the scores given by the students were considered exceptionally strong clinical support for our pedagogical strategy that combines educational resources and can be successfully implemented in other programmes.
Psychometry and empathy levels and its dimensions in postgraduate students of dental specialties
Authors: Díaz‐Narváez Víctor , Oyarzún‐Muñoz Marcela , Reyes‐Reyes Alejandro , Calzadilla‐Núñez Aracelis , Martínez Pilar Torres , González‐Valenzuela Catalina , Cornejo‐Fernández Nicole 
Published: January 2021

AbstractBackgroundEmpathy is an attribute that has an important role in the dentist‐patient therapeutic relationship, clinical care and adherence to treatment, amongst other benefits. The aim of this research was to determine empathy in dentists in the process of specialisation.Materials and MethodsThrough an observational and cross‐sectional study, all postgraduate students of Dentistry Faculty of Universidad Andrés Bello (Chile) were analysed (N = 195). The Jefferson Scale of Physician Empathy Scale was applied.ResultsThe results show an adequate reliability of the empathy measure (α = 0.819, ω = 0.928). A three‐factor structure is evidenced by confirmatory factor analysis (χ2/df = 1.445, GFI = 0.952, RMSEA = 0.047) and adequate factor invariance between men and women. Women showed greater empathy on the global scale and in the perspective adoption dimension, with no gender differences found in the dimension Compassionate care and putting oneself in the other's shoes (POOS). The median empathy reaches 120 points. Below, are placed, the specialty of oral rehabilitation (Med = 114.5), surgery (Med = 117) and periodontics (Med. = 117.5). With superior scores, temporomandibular disorder (Med. = 121), endodontics (Med. = 121), Orthodontics and dentofacial orthopedics Med. = 122), Implantology (Med. = 125) and Pediatric dentistry (Med. = 127.5) are located.ConclusionWomen were more empathetic than men. In general, empathy levels are relatively high, but the common feature in which all students examined in different specialties have low levels in dimension POOS.