bluuebunny/crossref_metadata_2025_split huggingface dataset:
Striving Through Adversities of Professional Life to Provide Better Care: A Content Analysis of News Articles and Online Blogs on Deteriorating Mental Health of Medicos
Authors: Saxena Swati , Rathore Bhanupriya 
Published: September 2024

Background: One of the noblest professions is medicine, which comprises ancillary services, medical students, and other paramedics. The challenges faced by the medical fraternity are infinite and uncertain. Aim: This study aims to thoroughly understand the professional challenges faced by medical professionals that can lead to mental health issues. Methods: A content analysis of 64 news articles and online blogs was done. The articles and blogs that addressed mental health issues among medical professionals were shortlisted. The data retrieved was accessed digitally between 2016 and 2024. Frequency analysis was done using QDA Miner Lite (free version). Results: The findings were summarized into six themes and 17 sub-themes, showing a high frequency of rising mental health issues among medicos, lack of organizational support, poor work-life balance, violence, and sacrificed health, with other less frequent codes like toxic seniority, hostile work culture, negative consequences of reporting mental health problems and hiding vulnerability to protect self-efficacy. Conclusion: The data retrieved from various news articles and blogs presents the personal experiences and real-life struggles of medical professionals. The outcome of this study is to understand the key issues affecting medicos at personal, professional, social, emotional, and spiritual levels.
Oxidative Stress in Depression: A Case-control Study of Serum MDA Levels and Lipid Levels in Patients With Depression in a Tertiary Care Hospital in South India
Authors: Bondade Swapna , Das Keya , Supriya R  , Vignesh Ramakrishna , Varghese Sinu 
Published: September 2024

Introduction: Numerous theories have been proposed to substantiate the etiopathogenesis of depression. Recently, the hypothesis involving the oxidative stress (OS) pathway has been explored. Hence, potential markers are also being investigated for their role in depression. We aimed to assess the serum malondialdehyde (MDA) and serum lipid levels in individuals with depression and controls and explore associated factors. Methodology: A semi-structured questionnaire, complete with a mandatory consent form and a reliable, validated scale, namely the Hamilton Depression scale (HAM-D), was used. The method of sampling was purposive, with 100 depression cases in the psychiatry outpatient being included and 50 age-matched, gender-matched controls. Blood was collected from both groups to evaluate serum MDA and serum Lipid levels. Appropriate statistics using SPSS 20 were administered. Results: Our study had a female preponderance in cases, with 38% having major depressive disorder (MDD), 50% of whom showed suicidal ideas, and 10% had a prior history of deliberate self-harm. Mean HAM-D scores were higher in cases than controls, 18.57 ± 6.02, and mean MDA levels were higher in cases, 2.5 ± 1.02 mmol/L. HDL levels were lower in depression cases compared to controls, 38.34 ± 7.442. An inverse correlation was seen between mean serum MDA levels and HDL levels in depression cases. A significant relationship was observed between the parameters of depression and serum MDA levels. Conclusion: Significantly elevated mean serum MDA levels were observed in depression cases, along with significantly lowered mean HDL values compared to controls. We found a positive correlation between serum MDA levels and the severity, recurrence, and suicidality of depression. An inverse relation was observed between serum MDA values and mean HDL levels in depression. This emphasizes the need for clinical vigilance in employing these biomarkers not merely for assessment but also for HDL as a preventive measure in depression.
Validation of a Malayalam Version of the Apathy Evaluation Scale
Authors: Cotton Kelly , Sivaraman Shaji Kunnukattil , Sathyan Sanish , Ayers Emmeline , Adhikari Dristi , Ceïde Mirnova E. , Sigamani Alben , Kumar Pradeep , Verghese Joe 
Published: September 2024

Background: The apathy evaluation scale (AES) measures apathy, but its usefulness as a screening tool in diverse populations is limited without translation into more languages. To date, there is no reported translation of the AES into Malayalam, a language spoken by over 32 million people in the southern Indian state of Kerala. In the present study, we aimed to validate the Malayalam version of the AES. Methods: Six hundred sixty-one community-dwelling older adults without dementia participating in the Kerala Einstein study completed the Malayalam AES. We assessed the internal consistency and the validity of the Malayalam AES, using another measure of apathy, as well as measures of depression and anxiety. We also used principal component analysis (PCA) to determine the dimensionality of the Malayalam AES. Finally, we assessed possible sex differences in apathy. Results: The Malayalam AES demonstrated high internal consistency and good validity, and the results of our PCA indicate that it has a three-component structure, as in the original English version and other translated versions. We found that while overall apathy scores were similar, the relationship with other neuropsychiatric symptoms differed by sex, with stronger relationships found in male participants compared to female participants. Conclusion: Our study provides another tool to screen for apathy in non-English-speaking populations, an important early risk factor for cognitive and functional decline, and enables future research across diverse cultures.
Rasch Analysis of the Chinese Version of the Nociception Coma Scale–Revised in Patients with Prolonged Disorders of Consciousness
Authors: Zheng Yuhang , Lin Xinyou , Huang Yuehong , Laureys Steven , Di Haibo 
Published: September 2024

Objectives The aim of this study was to analyze the Chinese version of the Nociception Coma Scale–Revised in patients with prolonged disorders of consciousness within the framework of Rasch modeling, including investigating the invariance of total scores across different etiologies of disorders of consciousness. Design Prospective psychometric study. Participants Patients with prolonged disorders of consciousness from the Rehabilitation and Neurology units in hospital. Interventions None. Main Outcome Measure The Nociception Coma Scale–Revised was undertaken by trained raters and the Coma Recovery Scale-Revised was used to assess patients’ consciousness. The psychometric properties within the Rasch model including item-person targeting, reliability and separation, item fit, unidimensionality, and differential item functioning were assessed. Results 84 patients with prolonged disorders of consciousness (mean age 53 years; mean injury 5 months; 42 with Minimally Conscious State and 42 with Unresponsive Wakefulness Syndrome) of 252 observations were enrolled in the study. Through the procedure of repeated assessment and differential item function, a lower item bias Rasch set was purified. The Rasch model assumptions were examined and met, with item reliability and validity meeting the recommended threshold. Conclusions The Chinese version of the Nociception Coma Scale–Revised demonstrated unidimensionality, good reliability and separation, and good item fit, but dissatisfied person fit and item-person targeting. The verbal subscale showed a notable discrepancy between person responses and the difficulty of the items, suggesting limited clinical significance.
Blackcurrant (Ribes nigrum L.) improves cholinergic signaling and protects against chronic Scopolamine-induced memory impairment in mice
Authors: da Costa Pauline , Schetinger Maria Rosa C , Baldissarelli Jucimara , Stefanello Naiara , Lopes Thauan F , Reichert Karine P , Assmann Charles E , Bottari Nathieli B , Miron Vanessa V , Vargas Fermina Francesca A , Gutierres Jessié M , da Cruz Ivana Beatrice M , Morsch Vera Maria 
Published: September 2024

Background: Blackcurrant ( Ribes nigrum L.) is a berry rich in anthocyanins, bioactive compounds known for their antioxidant and neuroprotective properties that benefit human health. Aims: This study aimed to investigate the effects of blackcurrant and its association with Donepezil on memory impairment, cholinergic neurotransmission, and antioxidant systems in a mouse model of amnesia induced by chronic administration of Scopolamine. Methods: Adult male Swiss mice were given saline, blackcurrant (50 mg/kg, orally), and/or Donepezil (5 mg/kg, orally) and/or Scopolamine (1 mg/kg, intraperitoneally). Results: Behavioral tests revealed that blackcurrant and/or Donepezil prevented the learning and memory deficits induced by Scopolamine. In the cerebral cortex and hippocampus, blackcurrant and/or Donepezil treatments prevented the increase in acetylcholinesterase and butyrylcholinesterase activities induced by Scopolamine. Scopolamine also disrupted the glutathione redox system and increased levels of reactive species; nevertheless, blackcurrant and/or Donepezil treatments were able to prevent oxidative stress. Furthermore, these treatments prevented the increase in gene expression and protein density of acetylcholinesterase and the decrease in gene expression of the choline acetyltransferase enzyme induced by Scopolamine. Conclusions: Findings suggest that blackcurrant and Donepezil, either alone or in combination, have anti-amnesic effects by modulating cholinergic system enzymes and improving the redox profile. Therefore, blackcurrant could be used as a natural supplement for the prevention and treatment of memory impairment in neurodegenerative diseases.
Antipsychotic medication in people with intellectual disability and schizophrenia: A 25-year updated systematic review and cross-sectional study
Authors: Courtial Elsa , Pouchon Arnaud , Polosan Mircea , Dondé Clément 
Published: September 2024

Objectives: To determine the efficacy and safety of antipsychotic medication for treating individuals with a dual diagnosis of intellectual disability (ID) and schizophrenia. Methods: We systematically reviewed the literature to explore the risks and benefits of antipsychotics for schizophrenia in ID. In addition, a cross-sectional retrospective study on the tolerance profiles of a representative ID and schizophrenia cohort was conducted. Results: From the systematic search, we retained 18 articles detailing information on 24 cases. In almost all cases, the antipsychotic improved psychotic symptoms (e.g., hallucinations, delusions, disorganization). Negative manifestations were also improved (blunted affects, amotivation, poor rapport), as were challenging behaviors in a few cases. The most commonly reported side effects were neurological (extra-pyramidal, movement disorder, epilepsy) and metabolic manifestations. In the retrospective cross-sectional study, we reported data on 112 participants with comorbid ID and schizophrenia. In all, 103 participants were antipsychotic-treated, of which 39% were on antipsychotic monotherapy. Of these, 35% were in the obesity range, 25% in the hyperglycemic range, and 25% in the dyslipidemia range. The body mass index did not differ between the groups. Conclusions: This study provides an initial evidence base underpinning the efficacy of antipsychotic drugs on schizophrenia in the ID population. Nevertheless, there may be an increased risk of metabolic side effects, hence, close monitoring of blood glucose, lipids, and weight should be implemented when prescribing antipsychotics to this population.
General Population Mortality Adjustment in Survival Extrapolation of Cancer Trials: Exploring Plausibility and Implications for Cost-Effectiveness Analyses in HER2-Positive Breast Cancer in Sweden
Authors: Kim Kun , Sweeting Michael , Wilking Nils , Jönsson Linus 
Published: September 2024

Background In economic evaluations of novel therapies, assessing lifetime effects based on trial data often necessitates survival extrapolation, with the choice of model affecting outcomes. The aim of this study was to assess accuracy and variability between alternative approaches to survival extrapolation. Methods Data on HER2-positive breast cancer patients from the Swedish National Breast Cancer Register were used to fit standard parametric distribution (SPD) models and excess hazard (EH) models adjusting the survival projections based on general population mortality (GPM). Models were fitted using 6-y data for stage I and II, 4-y data for stage III, and 2-y data for stage IV cancer reflecting an early data cutoff while maintaining sufficient events for comparison of model estimates with actual long-term outcomes. We compared model projections of 15-y survival and restricted mean survival time (RMST) to 15-y registry data and explored the variability between models in extrapolations of long-term survival. Results Among 11,224 patients compared with the observed registry 15-y RMST estimates across the disease stages, EH cure models provided the most accurate estimates in patients with stage I to III cancer, whereas EH models without cure most closely matched survival in patients with stage IV cancer, in which cure assumption was less plausible. The Akaike information criterion–averaged model projections varied as follows: −8.2% to +5.3% for SPD models, −4.9% to +5.2% for the EH model without a cure assumption, and −19.3% to −0.2% for the EH model with a cure assumption. EH models significantly reduced between-model variance in the predicted RMSTs over a 50-y time horizon compared with SPD models. Conclusions EH models may be considered as alternatives to SPD models to produce more accurate and plausible survival extrapolation that accounts for general population mortality. Highlights Excess hazard (EH) methods have been suggested as an approach to incorporate background mortality rates in economic evaluation using survival extrapolation. We highlight that EH models with or without a cure assumption can produce more accurate survival projections and significantly reduce between-model variability in comparison with standard parametric distribution models across cancer stages. EH models may be a preferred modeling method to reduce model uncertainty in health economic modeling since models that would otherwise have produced implausible extrapolations are constrained by the EH framework. Reduced uncertainty in economic evaluations will enhance the application of evidence-based health care decision making.
Effect of optimizing cerebral oxygen saturation on postoperative delirium in older patients undergoing one-lung ventilation for thoracoscopic surgery
Authors: Teng Peilan , Liu Henghua , Xu Derong , Feng Xuexin , Liu Miao , Wang Qingxiu 
Published: September 2024

Objectives This randomized controlled trial investigated whether the regional cerebral oxygenation saturation (rScO2)-guided lung-protective ventilation strategy could improve brain oxygen and reduce the incidence of postoperative delirium (POD) in patients older than 65 years. Methods This randomized controlled trial enrolled 120 patients undergoing thoracic surgery who received one-lung ventilation (OLV). Patients were randomly assigned to the lung-protective ventilation group (PV group) or rScO2-oriented lung-protective ventilation group (TPV group). rScO2 was recorded during the surgery, and the occurrence of POD was assessed. Results The incidence of POD 3 days after surgery—the primary outcome—was significantly lower in the TPV group (23.3% versus 8.5%). Meanwhile, the levels of POD-related biological indicators (S100β, neuron-specific enolase, tumor necrosis factor-α) were lower in the TPV group. Considering the secondary outcomes, both groups exhibited a lower oxygenation index after OLV, whereas partial pressure of carbon dioxide and mean arterial pressure were significantly increased in the TPV group. In addition, minimum rScO2 during surgery and mean rScO2 were higher in the TPV group than in the PV group. Conclusion Continuous intraoperative monitoring of brain tissue oxygenation and active intervention measures guided by cerebral oxygen saturation are critical for improving brain metabolism and reducing the risk of POD.
Risk factors for patients with tracheal stenosis: a systematic review and meta-analysis
Authors: Hong Siqi , Wu Xiaobing , Feng Haihuan , Zhang Qing , Wang Xiaohan , Chang Minmin , Chen Xiuli , Liu Weijuan 
Published: September 2024

Objective To systematically evaluate potential risk factors for tracheal stenosis and to provide a reference for the prevention and management of patients with this condition. Methods Databases were searched to identify studies of the risk factors for tracheal stenosis, from their inception to October 2023, then a meta-analysis was performed. The study was registered with PROSPERO under the registration number CRD42023428906. Results Ten studies of a total of 2525 patients were included. The meta-analysis showed that tracheotomy, diabetes, the duration of intubation, the duration of mechanical ventilation, respiratory tract infection, a high incision, and a ratio of intratracheal tube cuff diameter (C)/transverse diameter at the level of the clavicle (T) >150% were risk factors for the development of tracheal stenosis. Conclusion Measures such as shortening the duration of mechanical ventilation and intubation, reducing and avoiding tracheotomy after prolonged intubation, early tracheotomy in patients with obesity who require prolonged mechanical ventilation, appropriate choices of incision location and catheter, the maintenance of appropriate C/T, the prevention of respiratory infection, and the control of diabetes mellitus should limit the risk of tracheal stenosis.
Comparative Evaluation of Orthodontic Bonding Systems for Ceramic Brackets on Zirconia Crowns: A Shear Bond Strength and Adhesive Remnant Index Study
Authors: T Bhuvaneswaran , Vimala G. , Rao G. Usha , Anbarasu Prema 
Published: September 2024

Background The purpose of this research was to compare the adhesive residual score/adhesive remnant index (ARI) and shear bond endurance between the two orthodontic bonding systems for zirconia surface bonding: Self-etch (Scotchbond Universal) and total-etch (Transbond XT). Materials and Methods Color-coded acrylic blocks embedded with zirconia slabs were prepared, and the orthodontic brackets (ceramic) were bonded using either the total-etch or self-etch system. Group 1, represented by pink-colored blocks ( N = 12), accommodated 12 zirconia surfaces using the total-etch system, while Group 2, represented purple-colored blocks ( N = 12), also housed zirconia surfaces using the self-etch system. The shear bond strength was evaluated using an Instron Universal Testing Machine, and ARI scoring was done upon debonding. The statistical software SPSS was used for the analyses. Results The average bonding strength for the Scotchbond Universal etch system was 6.21 ± 0.76 MPa, while for the total-etch system, it was 5.59 ± 1.37 MPa. The ARI scores revealed that 83% of surfaces bonded with the self-etch system had no adhesive residue (ARI score 0), compared to 66% for the total-etch system. Conclusion The self-etch bonding agent demonstrated superior bond strength (6.2 MPa) compared to the total-etch system (5.6 MPa). Furthermore, it exhibited better ARI scores, indicating minimal adhesive residue. These findings suggest that the self-etch system is preferable for bonding ceramic brackets to zirconia crowns, offering improved bonding efficacy and ease of clean-up.
Impact of extracorporeal hemadsorption on mortality in critically ill COVID-19 patients in the intensive care unit
Authors: Çakin Özlem , Yüce Aktepe Melike , Harmandar Orbay , Deveci Kamil , Esra Yildirim Özlem , Kurtoğlu Erdal 
Published: September 2024

Background: The consequences of COVID-19, such as respiratory failure and mortality, require the search for fast and effective solutions. The aim of this retrospective study is to determine the effect of extracorporeal hemadsorption on mortality in severe COVID-19 cases hospitalized in the intensive care unit (ICU). Methods: Our study is retrospective, single-center, and observational. The study included ICU patients diagnosed with COVID-19 who received extracorporeal hemadsorption treatment between March 2020 and December 2020. Effects on mortality were examined by comparing pre- and post-hemadsorption values. Results: Seventeen patients were included in the study. The mortality rate in the study was 64.7%. After hemadsorption, an increase was observed in the lymphocyte numbers, APACHE-II, and SOFA values of the patients ( p = 0.026, 0.043, and 0.033; respectively). A significant decrease was observed in CRP and fibrinogen levels ( p = 0.003 and 0.005; respectively). In the non-surviving patient group, APACHE-II, SOFA, and procalcitonin values were found to be high before and after the procedure ( p = 0.002, 0.048, and 0.06; respectively). Conclusion: In COVID-19 patients, APACHE-II and SOFA scores may be useful in predicting the effectiveness of extracorporeal hemadsorption. Our study found that patients with higher APACHE-II and SOFA scores at baseline had a higher mortality rate after hemadsorption. These findings show that the use of intensive care scoring systems may be useful in determining which patients should receive extracorporeal hemadsorption and that hemadsorption should be performed in the early stages of the disease.
Randomised controlled trial comparing safety and efficacy of Urolift to monopolar TURP
Authors: Sheba Mostafa , El Gamal Farouk , Abd El Wahed Mohamed , Kotb Sameh , Meshref Alaa , Aly Hussein Hussien , Mostafa Zahran Amr 
Published: September 2024

Objectives: Benign Prostatic Hyperplasia (BPH) is the most common cause of the Lower Urinary Tract Symptoms (LUTS) in ageing men. TURP is still the gold-standard procedure for the treatment of LUTS-BPH, however new minimally invasive modalities like Urolift procedure has been introduced. Methods: Patients with prostate size up to 100 g were offered both treatment modalities. Hundred patients were included in the study, 100 in TURP group (group A) and 100 in Urolift group (group B). International Prostate Symptom Score (IPSS) was used at initial contact and for evaluation of response to treatment. Group A underwent TURP under regional anaesthetic, while group B underwent Urolift under sedation. Results: The mean age in both groups was 66.4 years. The IPSS score improvement among both groups is attached in the diagram. Group B patients had less hospital stay, better erectile and ejaculatory function compared to group B, and no stress incontinence was detected in group B while 6.7% of the patients in group A suffered some stress incontinence. Conclusion: Urolift has the benefit of preserving the ejaculatory function and less complications. Nevertheless, it has size limitations and the IPSS score improvement is less satisfactory when compared to TURP.