bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of empagliflozin as adjunctive therapy to citalopram in major depressive disorder: a randomized double-blind, placebo-controlled clinical trial
Authors: Zandifar Atefeh , Panahi Maryam , Badrfam Rahim , Qorbani Mostafa 
Published: February 2024

Abstract
Background
Major depressive disorder is one of the most common psychiatric disorders, which is associated with a high disease burden. Current treatments using antidepressants have limitations, so using medication with neuromodulating and anti-inflammatory properties alongside them could be helpful. In a clinical trial, we studied the effectiveness of empagliflozin, a blood sugar-lowering drug, as an adjunctive therapy to reduce the severity of depression symptoms.

Methods
A number of outpatients with moderate to severe depression (Hamilton Depression Rating Scale (HDRS) > = 17) who were not under related medication or had not taken medication for at least the last two months, had an age range of 18–60 years and had written informed consent to enter the study (N = 90) were randomly divided into two groups receiving placebo or empagliflozin (10 mg daily) combined with citalopram (40 mg daily) based on permuted block randomization method in an 8-week randomized, double-blind, placebo-controlled clinical trial. They were evaluated using the HDRS in weeks 0, 4, and 8.

Results
HDRS scores were equal to 28.42(± 3.83), 20.20(± 3.82), and 13.42(± 3.42) in the placebo group during weeks 0,4, and 8, respectively. These scores were 27.36(± 3.77), 13.76(± 1.40), and 7.00(± 1.13), respectively, for the group treated with empagliflozin. Compared to the control group, patients treated with empagliflozin using repeated-measures ANOVA showed greater improvement in reducing the severity of depression symptoms over time (p value = 0.0001).

Conclusions
Considering the promising findings in this clinical trial, further study of empagliflozin as adjunctive therapy in MDD with larger sample sizes and longer follow-ups is recommended.
Social poverty indicators with school bullying victimization: evidence from the global school-based student health survey (GSHS)
Authors: Chen Lin , Chen Ying , Ran Hailiang , Che Yusan , Fang Die , Li Qiongxian , Shi Yuanyu , Liu Shuqing , He Yandie , Zheng Guiqing , Xiao Yuanyuan 
Published: February 2024

Abstract
Background
School bullying is prevalent in children and adolescents. Bullying victims are seen higher risk of negative psychological outcomes. Previously published studies suggested that social indicators may pose significant influence on bullying victimization. However, the association between social poverty and bullying victimization has not been exclusively discussed.

Methods
In this cross-sectional study, we analyzed the association between 6 commonly used social poverty indicators (Poverty Headcount Ratio, PHR; Poverty Gap, PG; Squared Poverty Gap, SPG; monthly household per capita income, PCI; Watts’ Poverty Index, WPI; the Gini Index, Gini) and the prevalence of school bullying at country level by using the Global school-based Student Health Survey (GSHS) database.

Results
Altogether 16 countries were included into the final analysis, with school bullying victimization prevalence ranged from 12.9 to 47.5%. Bubble plots revealed statistically significant associations between the three indicators measuring absolute poverty level (PHR, PCI, WPI) and bullying victimization. Subsequently performed principal component regression indicated that, for all types of bullying victimization, the increase of absolute poverty level was related to elevated prevalence rates, and the association was particularly strong for verbal bullying victimization.

Conclusions
Our study results may suggest that absolute social poverty is an important parameter for constructing and implementing school bullying victimization intervention strategies and measures.
Sociodemographic and psychosocial risk factors of railway suicide: a mixed-methods study combining data of all suicide decedents in the Netherlands with data from a psychosocial autopsy study
Authors: Balt Elias , Mérelle Saskia , Popma Arne , Creemers Daan , Heesen Karlijn , van Eijk Nikki , van den Brand Isa , Gilissen Renske 
Published: February 2024

Abstract
Background
Railway suicide has profound implications for the victims and their family, and affects train drivers, railway personnel, emergency services and witnesses. To inform a multilevel prevention strategy, more knowledge is required about psychosocial and precipitating risk factors of railway suicide.

Methods
Data from Statistics Netherlands of all suicides between 2017 and 2021 (n = 9.241) of whom 986 died by railway suicide and interview data from a psychosocial autopsy of railway suicide decedents (n = 39) were integrated. We performed logistic regression analyses to identify sociodemographic predictors of railway suicide compared to other methods of suicide. The Constant Comparative Method was subsequently employed on interview data from the psychosocial autopsy to identify patterns in psychosocial risk factors for railway suicide.

Results
The strongest predictors of railway suicide compared to other suicide methods were young age (< 30 years old), native Dutch, a high educational level, living in a multi-person household (especially living with parents or in an institution), living in a rural area and a high annual household income of > 150.000 euros. Several subgroups emerged in the psychosocial autopsy interviews, which specifically reflect populations at risk of railway suicide. These subgroups were [1] young adult males with autism spectrum disorder who strived for more autonomy and an independent life, [2] young adult females with persistent suicidal thoughts and behaviours, [3] middle-aged males with a persistent mood disorder who lived with family and who faced stressors proximal to the suicide in personal and professional settings, [4] male out-of-the-blue suicides and [5] persons with psychotic symptoms and a rapid deterioration.

Conclusions
based on our findings we propose and discuss several recommendations to prevent railway suicide. We must continue to invest in a safe railway environment by training personnel and installing barriers. Additionally, we should adopt prevention strategies that align the needs of subgroups at increased risk, including young females who have attempted other methods of suicide and young males with autism spectrum disorder. Future research should determine the cost-effectiveness and feasibility of low-maintenance, automated interventions near crossings and psychiatric facilities.
Quality of life after emergency laparotomy: a systematic review
Authors: Khanderia Esha , Aggarwal Ravi , Bouras George , Patel Vanash 
Published: February 2024

Abstract
Background
Emergency laparotomy is a commonly performed surgical procedure that has higher post-operative morbidity and mortality than elective surgery. Previous research has identified that patients valued postoperative quality of life (QoL) more than the risk of mortality when deciding to undergo emergency surgery. Current pre-operative scoring and risk stratification systems for emergency laparotomy do not account for or provide prediction tools for post-operative QoL. This study aims to systematically review previous literature to determine post-operative QoL in patients who undergo emergency laparotomy.

Methods
A literature search was undertaken in Medline, EMBASE and the Cochrane Library to identify studies measuring post-operative QoL in patients who have had emergency laparotomy up to 29th April 2023. Mean QoL scores from the studies included were combined to calculate the average effect of emergency laparotomy on QoL. The primary outcome of the review was postoperative QoL after emergency laparotomy when compared with a comparator group. Secondary outcomes included the quality of included studies.

Results
Ten studies in the literature assessing the QoL of patients after emergency laparotomy were identified. Three studies showed that patients had improved QoL and seven showed worse QoL following emergency laparotomy. Length of time for QoL to return to baseline varied ranged from 3 to 12 months post-operatively. Length of hospital stay was identified as an independent risk factor for poorer QoL post-surgery.

Conclusions
Outcome reporting for patients who undergo emergency laparotomy should be expanded further to include QoL. Further work is required to investigate this and elicit factors that can improve QoL post-operatively.
Digital advance care planning with severe mental illness: a retrospective observational cohort analysis of the use of an electronic palliative care coordination system
Authors: Gill Rea Kaur , Droney Joanne , Owen Gareth , Riley Julia , Stephenson Lucy 
Published: February 2024

Abstract
Background
People living with severe mental illness (SMI) face significant health inequalities, including in palliative care. Advance Care Planning (ACP) is widely recommended by palliative care experts and could reduce inequalities. However, implementing ACP with this group is challenging. Electronic Palliative Care Coordination Systems such as Coordinate my Care (CMC) have been introduced to support documentation and sharing of ACP records with relevant healthcare providers. This study explores the use of CMC amongst those with SMI and aims to describe how those with a primary diagnosis of SMI who have used CMC for ACP, and makes recommendations for future research and policy.

Method
A retrospective observational cohort analysis was completed of CMC records created 01/01/2010–31/09/2021 where the service user had a primary diagnosis of SMI, with no exclusions based on comorbidities. Descriptive statistics were used to report on characteristics including: age, diagnosis, individual prognosis and resuscitation status. Thematic analysis was used to report on the content of patients’ statements of preference.

Results
1826 records were identified. Of this sample most (60.1%) had capacity to make treatment decisions, 47.8% were aged under 70, 86.7% were given a prognosis of ‘years’ and most (63.1%) remained for full cardio-pulmonary resuscitation in the event of cardio-pulmonary arrest. Records with completed statements of preferences (20.3%) contained information about preferences for physical and mental health treatment care as well as information about patient presentation and capacity, although most were brief and lacked expression of patient voice.

Discussion
Compared to usual CMC users, the cohort of interest are relatively able, younger people using CMC to make long-term plans for active physical and mental health treatment. ADM is a service user-driven process, and so it was expected that authentic patient voice would be expressed within statements of preference, however this was mostly not achieved.

Conclusions
This digital tool is being used by people with SMI but to plan for more than palliative care. This cohort and supporting professionals have used CMC to plan for longer term physical and mental healthcare. Future research and policy should focus on development of tailored digital tools for people with SMI to plan for palliative, physical and mental healthcare and support expression of patient voice.
Effect of acupuncture combined with rehabilitation training on sensory impairment of patients with stroke: a network meta-analysis
Authors: Wang Jiaqi , Wu Bangqi , Tong Yuanyuan , Wang Xuhui , Lu Zhaojun , Wang Wenqing 
Published: February 2024

Abstract
Background
The refractory and disabling nature of sensory disorders after stroke seriously affects patients' daily lives and reduces hospital turnover. Acupuncture, as an alternative therapy, is commonly used in combination with rehabilitation training to improve sensory disorders. To compare the effects of different acupuncture-related treatments combined with rehabilitation training on sensory impairment and the daily living ability of patients with stroke, we conducted a network meta-analysis to provide evidence-based findings for clinical practice.

Methods
Randomized controlled trials on the treatment of sensory disorders in patients with stroke were systematically retrieved from several databases, including China National Knowledge Infrastructure (CNKI), China Science and Technology Journal(VIP), Wanfang Database, Chinese Biological Medical (CBM), PubMed, Embase, Web of Science, Cochrane Library, and Clinical trials. The retrieval period ranged from January 2012 to December 2023. Two independent reviewers screened the included literature, extracted the data, and assessed the risk quality using Cochrane Handbook 5.1.0 and ReviewManager 5.4.1. Stata16.0 software was employed for data analysis. The study protocol was registered in PROSPERO: CRD42023389180.

Results
After screening, 20 studies were included, involving a total of 1999 subjects. The network meta-analysis results indicate that, compared to standard rehabilitation, acupuncture plus massage plus rehabilitation showed the most significant reduction in Numbness Syndrome Scores (MD = -0.71(-1.11,-0.31)). Acupuncture combined with rehabilitation demonstrated the most substantial improvement in Sensory Impairment Scores (MD = -0.59,(-0.68,-0.51)) and daily living ability of patients (MD = 17.16,(12.20,22.12)).

Conclusions
In comparison to standard rehabilitation, the combination of acupuncture-related treatments and modern rehabilitation training not only improves the symptoms of sensory impairment and numbness after stroke but also enhances the daily living ability of patients, especially when acupuncture is combined with rehabilitation. However, further demonstration is required to strengthen these conclusions.
Barriers and facilitators to the implementation of digital technologies in mental health systems: a qualitative systematic review to inform a policy framework
Authors: Berardi Chiara , Antonini Marcello , Jordan Zephanie , Wechtler Heidi , Paolucci Francesco , Hinwood Madeleine 
Published: February 2024

Abstract
Background
Despite the potential for improved population mental health and wellbeing, the integration of mental health digital interventions has been difficult to achieve. In this qualitative systematic review, we aimed to identify barriers and facilitators to the implementation of digital technologies in mental healthcare systems, and map these to an implementation framework to inform policy development.

Methods
We searched Medline, Embase, Scopus, PsycInfo, Web of Science, and Google Scholar for primary research articles published between January 2010 and 2022. Studies were considered eligible if they reported barriers and/or facilitators to the integration of any digital mental healthcare technologies. Data were extracted using EPPI-Reviewer Web and analysed thematically via inductive and deductive cycles.

Results
Of 12,525 references identified initially, 81 studies were included in the final analysis. Barriers and facilitators were grouped within an implementation (evidence-practice gap) framework across six domains, organised by four levels of mental healthcare systems. Broadly, implementation was hindered by the perception of digital technologies as impersonal tools that add additional burden of care onto both providers and patients, and change relational power asymmetries; an absence of resources; and regulatory complexities that impede access to universal coverage. Facilitators included person-cantered approaches that consider patients’ intersectional features e.g., gender, class, disability, illness severity; evidence-based training for providers; collaboration among colleagues; appropriate investment in human and financial resources; and policy reforms that tackle universal access to digital health.

Conclusion
It is important to consider the complex and interrelated nature of barriers across different domains and levels of the mental health system. To facilitate the equitable, sustainable, and long-term digital transition of mental health systems, policymakers should consider a systemic approach to collaboration between public and private sectors to inform evidence-based planning and strengthen mental health systems.

Protocol registration
The protocol is registered on PROSPERO, CRD42021276838.
Production and characterization of melanin pigment from black fungus Curvularia soli AS21 ON076460 assisted gamma rays for promising medical uses
Authors: Abd-EL-Aziz Amira S. , Abed Nermine N. , Mahfouz Amira Y. , Fathy Rasha Mohammad 
Published: February 2024

AbstractOwing to the growing need for natural materials in different fields, studying melanin production from biological sources is imperative. In the current study, the extracellular melanin pigment was produced by the fungus Curvularia soli AS21 ON076460. The factors that affect the production of melanin were optimized by the Plackett-Burman design (P-BD). The effect of gamma irradiation on melanin productivity was investigated. The maximum melanin yield (3.376 mg/L) was elicited by a stimulus of gamma irradiation at 1.0 kGy. The results evoked that, Curvularia soli AS21 ON076460 melanin exhibited excellent antimicrobial activity against all tested bacteria and fungi. Klebsiella pneumoniae ATCC 13883 and P. digitatum were mostly affected by melanin registering the inhibition zone diameters of 37.51 ± 0.012 and 44.25 ± 0.214 mm, respectively. Moreover, Curvularia soli AS21 ON076460 melanin indicated a significant antiviral efficacy (77% inhibition) of Herpes simplex virus (HSV1). The melanin pigment showed antioxidant activities with IC50 of 42 ± 0.021 and 17 ± 0.02 µg/mL against DPPH and NO, respectively. Melanin had cytotoxic action against human breast cancer and skin cancer cell lines (Mcf7and A431) as well as exerting a low percentage of cell death against normal skin cell lines (Hfb4). Melanin was effective in wound management of human skin cells by 63.04 ± 1.83% compared with control (68.67 ± 1.10%). The novelty in the study is attributed to the possibility of using gamma rays as a safe method in small economic doses to stimulate melanin production from the fungi that have been isolated. In summary, melanin produced from fungi has significant biological activities that encourage its usage as a supportive medical route.
Migrant well-being and undocumented status in South Korea: a cross-sectional assessment of physical, psychological, social well-being, and health behaviors
Authors: Lee Sun Yeop , Kim Woong-Han , Heo Jongho 
Published: February 2024

AbstractBackgroundA high burden of physical, mental, and occupational health problems among migrant workers has been well-documented, but data on undocumented migrant workers are limited and their well-being has rarely been compared to that of the general population.MethodsUsing data from a cross-sectional survey of non-professional migrant workers in South Korea in early 2021, we described their physical, psychological, social well-being and health behaviors across a wide range of outcomes, including self-rated health, occupational injury, cigarette smoking, heavy alcohol consumption, meal pattern, happiness, mental illness, social support, and social participation. The outcomes were first compared between documented and undocumented migrant workers in generalized linear regressions adjusting for potential confounders. Then, the well-being of the migrant workers was compared against that of the general population using data from the Korean Happiness Survey, which is a nationally representative survey of the South Korean general population conducted in late 2020. The parametric g-formula was performed to adjust for potential confounders.ResultsAfter adjusting for potential confounders, the undocumented migrant workers were less likely to be happy or participate in social communities, and much more likely to have anxiety or depression, smoke cigarettes, or engage in heavy alcohol consumption than the documented migrant workers. When compared to the general South Korean population, an evident social gradient emerged for happiness and mental illness; the undocumented experienced the worst outcome, followed by the documented, and then the general population. Also, the undocumented migrant workers were more likely to smoke cigarettes than the general population.ConclusionThe undocumented migrant workers face considerably greater challenges in terms of mental health and happiness, demonstrate higher rates of risky health behaviors such as smoking and heavy drinking, and experience a lack of social support and community integration. A stark social gradient in happiness, mental illness, and cigarette smoking exists among the documented, undocumented migrant workers and the general population in South Korea. Socio-structural factors are likely to play a crucial role in contributing to the suboptimal level of overall well-being of undocumented migrant workers. Policy-level interventions as well as interpersonal efforts are in urgent need.
The role and controversy of pelvic lymph node dissection in prostate cancer treatment: a focused review
Authors: Dong Baonan , Zhan Hui , Luan Ting , Wang Jiansong 
Published: February 2024

AbstractPelvic lymph node dissection (PLND) is commonly performed alongside radical prostatectomy. Its primary objective is to determine the lymphatic staging of prostate tumors by removing lymph nodes involved in lymphatic drainage. This aids in guiding subsequent treatment and removing metastatic foci, potentially offering significant therapeutic benefits. Despite varying recommendations from clinical practice guidelines across countries, the actual implementation of PLND is inconsistent, partly due to debates over its therapeutic value. While high-quality evidence supporting the superiority of PLND in oncological outcomes is lacking, its role in increasing surgical time and risk of complications is well-recognized. Despite these concerns, PLND remains the gold standard for lymph node staging in prostate cancer, providing invaluable staging information unattainable by other techniques. This article reviews PLND's scope, guideline perspectives, implementation status, oncologic and non-oncologic outcomes, alternatives, and future research needs.