bluuebunny/crossref_metadata_2025_split huggingface dataset:
A multidimensional strategy for uncovering comprehensive quality markers of Scutellariae Radix based on UPLC-Q-TOF-MS analysis, artificial neural network, network pharmacology analysis, and molecular simulation
Authors: Liu Meiqi , Zhao Xiaoran , Wen Jinli , Sun Lili , Huang Rui , Zhang Huijie , Liu Yi , Ren Xiaoliang 
Published: July 2024

IntroductionScutellariae Radix (SR), derived from the root of Scutellaria baicalensis Georgi, is a traditional Chinese medicine (TCM) for clearing heat and cooling blood. It has been used as a traditional herbal medicine and is popular as a functional food in Asian countries today.MethodsIn this study, UPLC-Q-TOF-MS was first employed to identify the chemical components in the ethanol extract of SR. Then, the extraction process was optimized using star point design-response surface methodology. Fingerprints of different batches and processed products were established, and chemical markers were screened through a combination of various artificial neural network models. Finally, network pharmacology and molecular simulation techniques were utilized for verification to determine the quality markers.ResultsA total of 35 chemical components in SR were identified, and the optimal extraction process was determined as follows: ultrasonic extraction with 80% methanol at a ratio of 120:1 for 70 minutes, with a soaking time of 30 minutes. Through discriminant analysis using various artificial neural network models, the samples of SR could be classified into two categories based on their growth years: Kuqin (dried roots of older plants) and Ziqin (roots of younger plants). Moreover, the samples within each category could be further clustered according to their origins. The four different processed products of SR could also be distinguished separately. Finally, through the integration of network pharmacology and molecular simulation techniques, it was determined that baicalin, baicalein, wogonin, norwogonin, norwogonin-8-O-glucuronide, skullcapflavone II, hispidulin, 8, 8"-bibaicalein, and oroxylin A-7-O-beta-D-glucuronide could serve as quality markers for SR.DiscussionThe primary factors affecting the quality of SR were its growth years. The geographic origin of SR was identified as a secondary factor affecting its quality. Processing also had a significant impact on its quality. The selected quality markers have laid the foundation for the quality control of SR, and this research strategy also provides a research paradigm for improving the quality of TCM.
The unintended consequences of school-based health and nutrition policies: a systematic review
Authors: Turner Samantha L. , Libert Alexis M. , Haase Grace , Pan Zhaoyi , Austin Andrew , Timko C. Alix 
Published: July 2024

BackgroundSignificant funding and attention are directed toward school-based health and nutrition interventions. Less attention is given to the potential unintended consequences of these policies, especially those that target children and adolescents. This systematic review aimed to elucidate the unintended consequences of school-based health and nutrition policies in the United States.MethodsWe conducted a systematic review, adhering to PRISMA guidelines, to analyze quantitative, qualitative, and mixed methods research conducted between January 2013 and September 2023. The search strategy encompassed three databases, identifying 11 articles that met the inclusion criteria.ResultsUnintended consequences were organized into four themes: disordered weight control behaviors, parental discomfort or encouragement of disordered weight control behaviors, eating disorder triggers, and financial losses. The analysis of disordered weight control behaviors indicates limited impact on youth, and we noted limited consensus in the assessment of these behaviors. We observed parent concerns about BMI screening and reporting as well as apprehensions about privacy and efficacy. There were fewer articles addressing eating disorder antecedents, although there was evidence that some youths with eating disorders considered school health class a trigger of their disorder. One study was identified that found an increase in food waste following replacement of sugar-sweetened beverages.ImplicationsFindings underscore the importance of comprehensive evaluation and consideration of unintended consequences in the development and implementation of school-based health policies. Recommendations include further longitudinal research, integrating obesity prevention with eating disorder prevention, and de-implementation when unintended consequences potentially outweigh benefits, such as in BMI screening and surveillance.Systematic Review Registration: Identifier CRD42023467355. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=467355
Postoperative factors associated with psychological well-being of living kidney donors: results of a retrospective and qualitative study
Authors: Galani Vasiliki , Mazzola Viridiana , Prada Paco , Bondolfi Guido 
Published: July 2024

IntroductionKidney transplantation from a living donor is the treatment of choice for end- stage kidney disease. Psychological implications of living kidney donation are of great importance, both during preliminary psychiatric assessment and post-donation follow-up. The identification of risk factors worsening the psychological well-being of living kidney donors (LKDs), before and after donation, remains challenging in terms of research.MethodsAt the University Hospitals of Geneva (HUG), our clinical observations and practice compelled us to establish post-donation follow-ups for LKDs at 6 months and 1 year. Pre-and post-donation sociodemographic, physical, psychological, and psychiatric data was collected from the medical records of 115 LKDs who underwent a complete physical and psychological evaluation during the period 2011-2018. We tested for any potential association between the variables under study.ResultsA qualitative and retrospective analysis of this data highlighted the impact of postoperative factors, such as pain, fatigue, recipient-donor relationship, and fulfillment of donors’ expectations, on the post-donation psychological well-being of LKDs.DiscussionWith regard to these findings, regular post-donation follow-ups, optimal care of postoperative pain and fatigue, as well as a solid therapeutic alliance with LKDs remain key points for clinicians involved in the dynamic process of living kidney donation.
Emotionally-oriented design in museums: a case study of the Jewish Museum Berlin
Authors: Zhang Zhihui , Lu Jing , Zhang Xiuying 
Published: July 2024

ObjectiveThis study examines the intricate interplay between architectural design and visitor emotional responses at the Jewish Museum Berlin, focusing on how specific spatial elements such as the Holocaust Tower, Garden of Exile, The Voids, and The Axis elicit varied affective experiences. The research aims to extend the discourse on environmental psychology and architectural empathy, particularly within the context of memorial museums.MethodEmploying a non-intrusive approach, the study gathered emotional response data using the Positive and Negative Affect Schedule (PANAS) from 113 museum visitors, with 102 valid responses analyzed. Environmental conditions such as light, sound, and spatial design were quantitatively measured to correlate with emotional responses captured at the end of visitors' tours across the designated museum spaces.ResultsFindings revealed that architectural elements significantly influence emotional responses. High levels of negative emotions like fear and anxiety were markedly evident in the Holocaust Tower due to its minimal lighting and stark concrete structure. Conversely, the Garden of Exile induced more positive emotions through its use of natural light and greenery, emphasizing the role of biophilic design in enhancing emotional well-being. Statistical analysis supported these observations, with variations in emotional impact across different spaces demonstrating the profound effect of architectural design on visitor experiences.ConclusionThis study confirms that a variety of design elements and spatial strategies not only facilitate the presentation of historical narratives but also actively sculpt the emotional involvement and experiences of visitors. Our findings highlight the efficacy of emotionally-oriented architectural design in deepening the impact and engagement of museum visitors, emphasizing the transformative power of these environments in shaping visitor perceptions and interactions.
Role of frailty in predicting outcomes after stroke: a systematic review and meta-analysis
Authors: Li Jing , Wan Jinping , Wang Hua 
Published: July 2024

BackgroundStroke is considered the second most common cause of death and the third leading cause of disability worldwide. Frailty, characterized by increased vulnerability to stressors, is emerging as a key factor affecting outcomes in older adults and stroke patients. This study aimed to estimate the prevalence of frailty in acute stroke patients and assess its association with mortality and poor functional outcome.MethodsMedline, Google Scholar, and Science Direct databases were systematically searched for English-language studies that included adult stroke patients (&gt;16 years), have defined frailty, and reported mortality and functional outcomes. Meta-analysis was done using STATA 14.2, and the results were expressed as pooled odds ratios (OR) with 95% confidence intervals (CI). Heterogeneity was assessed using the I2 statistic and the Chi-square test. Study quality was evaluated using the Newcastle Ottawa Scale (NOS).ResultsTwenty-five studies were included in the analysis. Frailty prevalence in stroke patients was 23% (95% CI 22% - 23%). Unadjusted analysis showed an OR of 2.66 (95% CI: 1.93 - 3.67) for mortality and 2.04 (95% CI: 1.49 - 2.80) for poor functional outcome. Adjusted estimates indicated an OR of 1.22 (95% CI: 1.1 - 1.35) for mortality and 1.21 (95% CI: 1.04 - 1.41) for poor functional outcome, with substantial heterogeneity for both adjusted and unadjusted analyses. No publication bias was detected for the prevalence of frailty. However, there was a publication bias for the association between frailty and mortality.ConclusionsFrailty was significantly associated with increased mortality and poorer functional outcomes in stroke patients. Our study highlights the need to focus on frailty in stroke patients to improve outcomes and quality of life. Further research should aim to standardize assessment of frailty and reduce heterogeneity in study outcomes.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/#searchadvanced, CRD42023470325.
The effect of virtual reality simulation on nursing students’ communication skills: a systematic review and meta-analysis
Authors: Cho Mi-Kyoung , Kim Mi Young 
Published: July 2024

Virtual reality simulation (VRS) allows individuals to experience a sense of presence in a virtual environment, and it has been increasingly adopted as a novel teaching method in nursing education. VRS can have positive effects, such as patient safety, privacy assurance in healthcare, and enhanced interest and immersion in education. It is important to synthesize the results to date to determine if VRS has the potential to improve communication skills in practical nursing students. This systematic literature review and meta-analysis investigated the effect of VRS on the enhancement of communication skills among nursing students. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were employed for systematic review and meta-analysis. The following “PICO” details were considered: population—nursing students, intervention—VRS targeting communication skills enhancement, comparator—control groups without intervention or those undergoing general classes, and outcomes—communication skills. The search strategy yielded 301 results from nine databases, and 10 studies were selected for inclusion in our analysis. To calculate the overall effect sizes of the primary and secondary outcomes in the included studies, we used MIX 2.0 Pro (Version 2.0.1.6, BiostatXL, 2017) for the meta-analysis. The overall effect size for communication skills was 0.44, signifying a significant effect. A meta-regression analysis examining communication skills revealed significant results for the following factors: Fund (Ref.: No), outcome measurement time (Ref.: Immediately), outcome follow-up (Ref.: No), and debriefing (Ref.: No). Considering factors such as variations in sample size, research approaches, and the effects of independent studies on communication skills, this systematic literature review and meta-analysis suggests that VRS significantly improves nursing students’ communication skills overall.Systematic review registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42023439064.
Impact of epidemic prevention policies on public vaccination willingness: empirical research in China
Authors: Zhong Jie , Zhuang Yue , Zhang Miao 
Published: July 2024

BackgroundThe sudden emergence of the COVID-19 pandemic in early 2020 posed an enormous threat to public health. Vaccination is currently recognized as the most cost-effective preventive and control measure against the COVID-19 pandemic worldwide and is the key to constructing a line of defense against the virus, while the epidemic prevention policies adopted by governments have an important impact on the protective behavior of the public. The purpose of this study is to analyze the mechanism by which the stringency of epidemic prevention policies affects public vaccination willingness and to explore the mediating effect of public risk perception.MethodsA cross-sectional survey was conducted among 387 adults from December 2022 to June 2023 in China. A multiple linear regression model was used to explore the impact of epidemic prevention policy stringency on public vaccination willingness, and a hierarchical regression model was used to test the mediating effect of public risk perception.ResultsOur results showed that public vaccination willingness increased by approximately 45.5% for every one-unit increase in the stringency of the epidemic prevention policies, which shows that the stringency of epidemic prevention policies has a significant positive influence on public vaccination willingness. In addition, public risk perception increased by approximately 38.9% during the period of stringent government policies on epidemic prevention. For every one-unit increase in risk perception, public vaccination willingness increased by approximately 40.9%, and the relationship between the stringency of epidemic prevention policies and public vaccination willingness was partially mediated by risk perception.ConclusionThe stricter the epidemic prevention policies, the stronger the public vaccination willingness; risk perception plays a mediating effect between the stringency of epidemic prevention policies and public vaccination willingness. This finding is particularly important for exploring and analyzing the factors influencing public vaccination willingness and for improving public health.
Mediating mechanism of posttraumatic growth as buffers of burnout and PTSD among nurses during the COVID-19 pandemic
Authors: Sim Jae-Chang , Cha Sun-Kyung , Im Sun-Young 
Published: July 2024

ObjectiveThe study aims to investigate factors that prevent burnout (BO) and symptoms of posttraumatic stress disorder (PTSD) while facilitating posttraumatic growth (PTG) among nurses combating the coronavirus disease 2019 (COVID-19) pandemic, with the purpose of validating the mediating effects of PTG.MethodsA total of 247 nurses who provided patient care during the COVID-19 pandemic were enrolled, and a questionnaire was used to measure BO, PTSD, and PTG, data on deliberate rumination, emotional expression, adaptive cognitive emotion regulation (CER), maladaptive CER, and social support. The mediation path models for the effects of the predictors on BO and PS through the mediation of PTG were analyzed using the R Lavaan package.ResultsThe results showed that deliberate rumination, emotional expression, and adaptive CER significantly increased PTG, while PTG significantly reduced BO and PTSD symptoms (PSs). However, maladaptive CER did not have a significant effect on PTG and only had significant direct effects on BO and PS. Bootstrapping confirmed that PTG significantly mediated the effects of all predictors. It partially mediated the effects of deliberate rumination and adaptive CER and completely mediated the effects of emotional expression.ConclusionBased on the results, it has been supported that deliberate rumination, emotional expression, and adaptive CER should be addressed as important variables in psychological interventions addressing nurses’ adversities during the pandemic. These variables can prevent BO and PS by facilitating PTG.
Association of heavy metals exposure with lower blood pressure in the population aged 8–17 years: a cross-sectional study based on NHANES
Authors: Liang Yongzhou , Zhang Minjie , Jin Wenhao , Zhao Liqing , Wu Yurong 
Published: July 2024

BackgroundThe existing evidence regarding the joint effect of heavy metals on blood pressure (BP) in children and adolescents is insufficient. Furthermore, the impact of factors such as body weight, fish consumption, and age on their association remains unclear.MethodsThe study utilized original data from the National Health and Nutrition Examination Survey, encompassing 2,224 children and adolescents with complete information on 12 urinary metals (barium, cadmium, cobalt, cesium, molybdenum, lead, antimony, thallium, tungsten, uranium, mercury and arsenic), BP, and core covariates. Various statistical methods, including weighted multiple logistic regression, linear regression, and Weighted Quantile Sum regression (WQS), were employed to evaluate the impact of mixed metal exposure on BP. Sensitivity analysis was conducted to confirm the primary analytical findings.ResultsThe findings revealed that children and adolescents with low-level exposure to lead (0.40 μg/L, 95%CI: 0.37, 0.42), mercury (0.38 μg/L, 95%CI: 0.35, 0.42) and molybdenum (73.66 μg/L, 95%CI: 70.65, 76.66) exhibited reduced systolic blood pressure (SBP) and diastolic blood pressure (DBP). Conversely, barium (2.39 μg/L, 95%CI: 2.25, 2.54) showed a positive association with increased SBP. A 25th percentile increase in the WQS index is significantly associated with a decrease in SBP of 0.67 mmHg (95%CI, −1.24, −0.10) and a decrease in DBP of 0.59 mmHg (95% CI, −1.06, −0.12), which remains statistically significant even after adjusting for weight. Furthermore, among individuals who consume fish, heavy metals have a more significant influence on SBP. A 25 percentile increase in the WQS index is significantly associated with a decrease of 3.30 mmHg (95% CI, −4.73, −1.87) in SBP, primarily attributed to mercury (27.61%), cadmium (27.49%), cesium (17.98%), thallium (8.49%). The study also identified a declining trend in SBP among children aged 10–17, whereas children aged 11–18 exhibited lower levels of systolic and diastolic blood pressure, along with a reduced risk of hypertension.ConclusionSome heavy metals demonstrate an inverse association with the BP of children and adolescents, particularly notable in groups with fish consumption and older children and adolescents. Future studies are warranted to validate these findings and delve deeper into the interplay of heavy metals.
Comparison of three device generations of the StepWatch Activity Monitor: analysis of model version agreement in pediatric and adult independent ambulators
Authors: Stevens Wilshaw R. , Barrett Cody , Jeans Kelly A. 
Published: July 2024

PurposeDevices such as the StepWatch Activity Monitor (SAM) have been available for 20 years and have been shown to accurately measure ambulatory activity. This study aimed to evaluate the agreement among the three generations of the StepWatch Activity Monitor (SW3, SW4, and SW5) with respect to stride count.MethodsA total of 36 participants (age range, 6–55 years) participated in this institutional review board-approved study. The participants concurrently wore three different SAM model devices on the same leg and performed a 6-min walk test (6MWT). A research staff member of the laboratory manually counted the number of strides for the first 2 min of the test (2MWT). Agreement among the device models was evaluated by calculating ANOVAs and interclass correlation coefficients (ICCs) and creating Bland–Altman plots.ResultsThere was no significant difference among the model versions during the 6MWT and 2MWT (p &gt; 0.05). The ICC for the total stride count was 0.993 (95% CI = 0.988–0.996) during the 2MWT and 0.992 (95% CI = 0.986–0.996) during the 6MWT. There was a near-perfect agreement (ICC ≥ 0.990) of each model version to the manually counted strides during the 2MWT. The systematic bias of all three SAM model versions was &lt;1 step.ConclusionsThe results from the present study demonstrate that the stride counts among all three devices are comparable and relative to the manual stride count. All three SAM model versions had an ICC of &gt;0.90. Researchers can safely incorporate historical data from previous SAM model versions with newer data collected with the latest SAM model version.
Needle size for thyroid fine needle aspiration cytology. A single institution experience
Authors: Cianci Pasquale , Tumolo Rocco , Conversano Ivana , Travaglia Damiano , Trigiante Giuseppe , Lantone Giuliano , Lizzi Vincenzo , Cappiello Miriam , Montagna Marco , Curci Fabio Pio , Restini Enrico 
Published: July 2024

BackgroundFine needle aspiration cytology (FNAC) is an invasive diagnostic technique which is widely used for the cytological diagnosis of thyroid nodules. This procedure is generally widely tolerated by patients, albeit often accompanied by local pain and discomfort. Despite various proposals of execution methods, no approach is universally accepted,especially regarding the size of the needle to be used for sampling. Needle gauge preferences vary across regions, with 25-gauge needles more common in Western countries and 22-gauge needles favored in Asian countries. Complications associated with larger needles have been studied but remain inconclusive.Materials and methodsOver one year, we conducted 300 FNAC procedures under ultrasound guidance, employing both 22-gauge and 25-gauge needles. In no patient was local anesthesia performed before starting the procedure, which in all was performed by the same operator. Similarly the cytological examination of the material taken was performed by a single operator. Patients, 105 males and 195 females, were divided into two groups of 150 each based on the needle size used.ResultsPatients treated with 22-gauge needles reported higher levels of pain during the procedure and increased discomfort afterward. Similarly, a greater incidence of hematomas and vasovagal reactions was noted in this group. However, the cell sample obtained and diagnostic response rates were consistent across both groups.ConclusionOn the basis of our observations we concluded that the size of the needle used is irrelevant for the purposes of the diagnostic result, as long as the procedure is performed by expert personnel. However, the 25-gauge needle is preferable because it's more tolerated and accepted by patients. Our results do not represent a single and conclusive verdict, but they could represent the starting point for further research.