bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of and factors influencing Hikikomori in Osaka City, Japan: A population-based cross-sectional study
Authors: Kanai Koji , Kitamura Yuri , Zha Ling , Tanaka Kenta , Ikeda Manabu , Sobue Tomotaka 
Published: April 2024

Objectives: Hikikomori is commonly defined as a social condition in which individuals avoid social participation and relationships beyond their family members by confining themselves to a room or their house for 6 months or longer. Hikikomori has been predominantly considered a problem among young people; however, as the population is ageing, hikikomori has also emerged as a social issue among adults. Nevertheless, no comparative studies have examined the differences in the factors associated with hikikomori among teenagers/young adults and middle-aged/older adults. Thus, this phenomenon has not been thoroughly examined, and it remains unclear whether the risk factors vary between teenagers/young adults and middle-aged/older adults. Based on the Japan Cabinet Office’s definition of hikikomori, this cross-sectional study evaluated the prevalence and related factors of hikikomori among the working age population (15–64 years), utilising univariate and multivariate analyses. The study also compared differences in the prevalence of and factors related to hikikomori between teenagers/young adults and middle-aged/older adults. Methods: We distributed self-administered questionnaires to individual participants and their families between 24 December 2020 and 18 January 2021. Results: Data from an anonymised sample of 3,092 individuals (split into two groups of 15–39 and 40–64 years) were subjected to analysis. The results revealed a hikikomori prevalence of 2.3% in the target population; the prevalence rate was 2.12% among individuals aged 15 to 39 years and 2.42% among those aged 40 to 64 years. The analysis demonstrated strong correlations between hikikomori and several factors, including unemployment, truancy, a history of psychiatric consultation or hospitalisation, being male and the absence of ibasho, which is defined as a place where individuals can feel peace, security, acceptance and belonging. The factors associated with hikikomori differed between teenagers/young adults and middle-aged/older adults. Conclusion: Our findings, thus, contribute to existing research by providing a comparative analysis of risk factors across different age groups.
The Role of Sensory Impairment in Cognitive Health Appraisal: A Study of Older Korean Americans Living in Subsidized Senior Housing
Authors: Jang Yuri , Park Juyoung , Chung Soondool , Lewis Charity , Haley William E. , Kim Miyong T. 
Published: April 2024

Objectives We examined how the association between cognitive performance and cognitive health appraisal would be moderated by vision and/or hearing impairment. Methods Data were collected from 315 older Korean–American residents in subsidized senior housing in Los Angeles ( M age = 79.4 years). Linear regression models examined the direct and interactive effects of cognitive performance, vision impairment, and hearing impairment on cognitive health appraisal. Results Negative appraisal of cognitive health was associated with lower cognitive performance and poorer ratings for vision and hearing. Moreover, we found a significant interaction between cognitive performance and hearing impairment ( β = .13, p < .05), as well as a three-way interaction among cognitive performance, vision impairment, and hearing impairment ( β = .12, p < .05). Discussion The association between objective and subjective measures of cognition was weakened when hearing was impaired. Such a pattern was further evident when both vision and hearing were impaired.
Effect of Cryptotanshinone on BDNF/TrkB Pathway in Hippocampus of Chronic Stress-induced Depression Rats
Authors: Lin Shaomei , Wu Shuifa , Liao Wanting , Chen Wanqiong , Cai Congyi , Zhang Yin , Chen Mingzhu 
Published: April 2024

Background Cryptotanshinone (CTS) is a monomer possessing a diverse array of pharmacological properties, primarily derived from Salvia miltiorrhiza. CTS was examined for its impact on rats with depression subjected to chronic unpredictable mild stress (CUMS) in this study. Materials and Methods Depression-like behavior of rats was established by isolated feeding combined with CUMS for 28 days, with CTS (7/14/21 mg/kg) or fluoxetine (5 mg/kg) administered once daily during this time. A comprehensive evaluation was performed, including body weight assessment, sucrose preference test, forced swimming test, and open field test. Hematoxylin-eosin staining was conducted to detect pathological changes in hippocampal CA1 neurons. Western blot analysis was employed to assess the brain-derived neurotrophic factor (BDNF), tyrosine kinase receptor B (TrkB), Ras-related C3 botulinum toxin substrate 1 (Rac1), and Cofilin expression levels in the hippocampus. Results The depression rat model was successfully constructed. CTS can significantly improve impaired neurons in the hippocampal CA1 area, depression-like behaviors, and weight loss in CUMS-induced rats. Moreover, CTS reversed the down-regulation of BDNF/TrkB and Rac1/Cofilin in the CUMS-induced rats’ hippocampus. Conclusion CTS demonstrates the therapeutic potential for depression by improving depression-like behaviors and ameliorating impaired neurons in the hippocampal CA1 area, and the mechanisms may involve the up-regulation of BDNF/TrkB and related signaling proteins Rac1/Cofilin.
Baicalin Inhibits VSMC Phenotypic Transition and Ameliorates Atherosclerosis via GSK3β-TCF21 Signaling Pathway
Authors: Huo Meng , Lin Jingjing , Xu Qiaoqiao , Zhang Haina , Ye Qizhen 
Published: April 2024

Background Atherosclerosis (AS) is the pathological basis of acute myocardial infarction, acute stroke, and other acute critical illnesses. Vascular smooth muscle cell (VSMC) phenotypic transformation plays a remarkable role in the occurrence and development of AS. Previous studies have found that GSK3β-TCF21 is a key signaling pathway regulating VSMC phenotypic transformation. Baicalin is an important herbal monomer for cardiovascular protection, but whether it can regulate the GSK3β-TCF21 signaling pathway and VSMC phenotypic transformation remains unclear. Purpose The study aimed to explore the role of Baicalin in AS and VSMC phenotypic transformation and whether the GSK3β-TCF21 signaling pathway participates in this process. Materials and Methods In this study, through the AS mouse model and ox-LDL-induced VSMC phenotypic transformation model in vitro, the effect of Baicalin on the GSK3β-TCF21 signaling pathway and VSMC phenotypic transformation was investigated. Results Pathological staining showed that the AS plaque area of the Baicalin group decreased significantly ( p < 0.001). The expression of the marker gene (TAGLN, ACTA2, CNN1, and MYH11) of VSMC phenotypic transformation was significantly increased ( p < 0.001) after Baicalin treatment. Baicalin could activate GSK3β and increase the expression of TCF21 significantly ( p < 0.001) to inhibit VSMC phenotypic transition. Inhibiting the GSK3β-TCF21 signaling pathway was able to reduce the effects of Baicalin on reducing VSMC phenotypic transition and protecting AS. Conclusion Our study indicates that Baicalin is protective in inhibiting VSMC phenotypic transformation and ameliorating AS by regulating GSK3β-TCF21.
Daprodustat: A Hypoxia-Inducible Factor–Prolyl Hydroxylase Inhibitor for Anemia of Chronic Kidney Disease
Authors: Johnson Haley N. , Prasad-Reddy Lalita 
Published: April 2024

Objective: The objective was to review the safety and efficacy of daprodustat, a hypoxia-inducible factor–prolyl hydroxylase inhibitor (HIF-PHI) in the treatment of anemia of chronic kidney disease (CKD). Data Sources: A literature search was conducted in MEDLINE, EMBASE, and ClinicalTrials.gov using the keywords “daprodustat,” “GSK1278863,” and “hypoxia-inducible factor-prolyl hydroxylase inhibitors” from January 2010 through November 2023. Study Selection and Data Extraction: Literature was included if it evaluated pharmacology, pharmacokinetics, efficacy, and/or safety of daprodustat in human subjects and was reported in English. The manufacturer’s product monograph was also utilized. Data Synthesis: Daprodustat significantly increased hemoglobin levels in CKD patients on dialysis (difference 0.18 g/dL) and not on dialysis (difference 0.08 g/dL) over 52-week treatment periods compared with erythropoiesis stimulating agents (ESA) in Anemia Studies in CKD: Erythropoiesis via a Novel PHI Daprodustat (ASCEND)-D and ASCEND-ND, respectively. First occurrence of major adverse cardiovascular events (MACEs) was similar between daprodustat and ESAs in both trials. Relevance to Patient Care and Clinical Practice in Comparison to Existing Drugs: Daprodustat can be used in patients with CKD on dialysis and already receiving an ESA for at least 6 weeks to further increase serum hemoglobin levels without increasing the risk of MACE. Adverse effects of daprodustat that may occur more than ESAs include headache, emesis, and thrombosis. Conclusions: Daprodustat is a novel oral, non-iron therapy for treatment of anemia of CKD. It was Food and Drug Administration approved in 2023 in patients already receiving dialysis for at least 4 months but not in non-dialysis patients. Long-term data for safety and additional benefits are pending.
Abbreviated Urine Collection Compared With 24-Hour Urine Collection for Measuring Creatinine Clearance in Adult Critically Ill Patients: A Systematic Review
Authors: Saad Mohamed Omar , Mohamed Adham , Mohamed Ibrahim Mohamed Izham 
Published: April 2024

Objective: To evaluate the accuracy of abbreviated urine collection (≤12 hours) compared with 24-hour urine collection for measuring creatinine clearance (CrCl) in critically ill adult patients. Data Sources: We searched PubMed, Embase, Web of Science, Google Scholar, and ProQuest Dissertations and Thesis Global; screened reference lists of included studies; and contacted the authors when needed. English studies only were considered with no restriction on dates. Study Selection and Data Extraction: After duplicate removal, 2 reviewers screened titles/abstracts, reviewed full-text articles, and extracted data independently. Studies that compared abbreviated versus 24-hour urine collection for measuring CrCl were included. We assessed the risk of bias using the QUADAS-2 tool. We extracted correlation coefficients, mean prediction errors (ME)—as a measure of bias, and root mean squared prediction errors (RMSE)—as a measure of precision. Data Synthesis: Five studies were included, comprising 528 adult critically ill adults from surgical, medical, and trauma intensive care units (ICUs). Three studies had high risk of bias, and 2 had low risk. The studies evaluated different durations of urine collection, including 30-minute, 2-hour, 4-hour, 6-hour, and 12-hour. Mean 24-hour CrCl ranged from 57 mL/min/1.73 m2 to 103 mL/min. Abbreviated urine collection led to CrCl that correlated well with the 24-hour measured CrCl (correlation coefficient ranged from 0.8 to 0.95). Mean prediction error ranged from 5 mL/min/1.73 m2 to 16 mL/min (from 8% to 25% of the 24-hour CrCl). Root mean squared prediction error calculated from 1 study was 30.5 mL/min/1.73 m2. Relevance to Patient Care and Clinical Practice: Abbreviated urine collection is used to measure CrCl for renal drug dosing in critically ill patients, but its accuracy is not well-established. Conclusions: Abbreviated urine collection may overestimate CrCl compared with 24-hour urine collection. Larger, well-conducted studies are needed to evaluate the accuracy of CrCl measured using different durations of urine collection in critically ill patients.
Forefoot Morphotypes in Cavovarus Feet: A Novel Assessment of Deformity
Authors: Malhotra Karan , Patel Shelain , Cullen Nicholas , Welck Matthew 
Published: April 2024

Background: The cavovarus foot is a complex 3-dimensional deformity. Although a multitude of techniques are described for its surgical management, few of these are evidence based or guided by classification systems. Surgical management involves realignment of the hindfoot and soft tissue balancing, followed by forefoot balancing. Our aim was to analyze the pattern of residual forefoot deformities once the hindfoot is corrected, to guide forefoot correction. Methods: We included 20 cavovarus feet from 16 adult patients with Charcot-Marie-Tooth who underwent weightbearing CT (mean age 43.4 years, range: 22-78 years, 14 males). Patients included had flexible deformities, with no previous surgery. Using specialized software (Bonelogic 2.1, Disior) a 3-dimensional, virtual model was created. Using morphologic data captured from normal feet in patients without pathology as a guide, the talonavicular joint of the cavovarus foot was digitally reduced to a “normal” position to simulate the correction that would be achieved during surgical correction. Models of the corrected position were exported and geometrically analyzed using Blender 3.64 to identify anatomical trends. Results: We identified 4 types of cavovarus forefoot morphotypes. Type 0 was defined as a balanced forefoot (2 cases, 10%). Type 1 was defined as a forefoot where the first metatarsal was relatively plantarflexed to the rest of the foot, with no significant residual adduction after talonavicular joint correction (12 cases, 60%). Type 2 was defined as a forefoot where the second and first metatarsals were progressively plantarflexed, with no significant adduction (4 cases, 20%). Type 3 was defined as a forefoot where the metatarsals were adducted after talonavicular derotation (2 cases, 10%). Conclusion: In this relatively small cohort, we identified 4 forefoot morphotypes in cavovarus feet that might help surgeons to recognize and anticipate the residual forefoot deformities after hindfoot correction. Different treatment strategies may be required for different morphotypes to achieve balanced correction. Level of Evidence: Level IV, retrospective case series.
Examining Cognitive Disengagement Syndrome in Relation to Social Problem Solving in Young Adults
Authors: Miller Melissa C. , Shapiro Steven K. , Becker Stephen P. 
Published: April 2024

Objective: Cognitive disengagement syndrome (CDS), previously referred to as sluggish cognitive tempo (SCT), is characterized by symptoms such as excessive daydreaming, mental confusion, and hypoactivity. CDS symptoms are associated with emotional, social, and daily life impairments. The way in which one solves problems in their daily life is associated with experiences of further problems, such that maladaptive problem-solving can lead to further physical and psychological problems. However, there is limited information on how CDS symptoms are associated with problem solving. The current study examined CDS symptoms in relation to different social problem solving approaches. Method: A total of 280 college students (ages 18–23 years; 77.9% female) completed measures of psychopathology symptoms and social problem solving. Results: Above and beyond ADHD and internalizing symptoms, CDS symptoms were independently associated with negative problem orientation and avoidance style domains of maladaptive problem solving. Conclusion: Findings indicate that CDS symptoms are related to specific difficulties with social problem solving. CDS symptoms may lead to difficulties attending to problems or working through relevant steps needed to identify solutions for the problem, which may then lead to avoidance and social withdrawal. Longitudinal research is needed to evaluate maladaptive problem solving as a potential mechanism in the association between CDS, social withdrawal, and internalizing symptoms.
Cystoid macular edema occurring after intracameral bimatoprost implantation
Authors: Bettach Emmanuel , Wiener Rony , Brosh Koby , Zadok David , Goldberg Mordechai 
Published: April 2024

Purpose This case report aims to report the development of cystoid macular edema (CME) unilaterally following the administration of bimatoprost implant (Durysta) injections in both eyes for the treatment of primary open-angle glaucoma (POAG). Observations An 84-year-old female patient, previously diagnosed with POAG, underwent bimatoprost implant (Durysta) injections in both eyes, spaced one month apart. Subsequently, the patient experienced a gradual decline in visual acuity in her left eye attributed to the development of CME. The condition resolved following a treatment regimen involving topical dexamethasone and nepafenac. Conclusion The use of bimatoprost implant may lead to the occurrence of CME. Ophthalmologists must vigilantly monitor patients post-implantation, especially if they exhibit visual symptoms or have risk factors for a CME.
Prevalence and incidence of multiple sclerosis in Turkey: A nationwide epidemiologic study
Authors: Öztürk Bilgin , Taşkıran Esra , Demir Serkan , Tuncer Meryem Aslı , Kürtüncü Murat , Karabudak Rana , Siva Aksel , Efendi Hüsnü , Ata Naim , Ülgü Mustafa Mahir , Birinci Şuayip 
Published: April 2024

Background: Many studies on multiple sclerosis (MS) reveal different prevalence and epidemiologic results. Objectives: In this study, we aimed to determine the epidemiologic profile of MS using official health records in Turkey. Methods: Patients diagnosed with MS from the official health data of the Ministry of Health, representing the entire population of Turkey, were included in the study. Prevalence and incidence calculations were performed using the data on gender, age, year of birth, city of residence, and year of diagnosis. Results: As a result of the study, the number of patients with the ICD code G35 was determined as 201,061 and the number of patients with this code entered at least three times was determined as 82,225. The prevalence of MS in Turkey was calculated as 96.4 per 100,000 and the female/male ratio as 2.1/1. The incidence of MS in 2022 was 6.2 per 100,000 and the mean patient age was 43.1 ± 13.3 years (female: 43.0 ± 13.1 vs male: 43.2 ± 13.7) while the mean age at first diagnosis was 34.0 ± 13.0 (female: 33.6 ± 12.6 vs male: 34.9 ± 13.7). Conclusion: The research was conducted via Official Database of Turkey, which includes population of 85 million and provides valuable insights into the prevalence and incidence rates of this chronic disease.
The appointment-based model in community pharmacies: Patient demographics and reimbursable clinical services uptake in Ontario
Authors: Tilli Tiana , Mathers Annalise , Lin Qiqi , Bhaidani Saleema , Baker Jen , Wei Louis , Grootendorst Paul , Cadarette Suzanne M. , Dolovich Lisa 
Published: April 2024

Background: Community pharmacies typically require patients to request medication refills. The appointment-based model (ABM) is a proactive approach that synchronizes refills and schedules patient–pharmacist appointments. These appointments provide opportunities for medication reviews, medication optimization and health promotion services. The primary aim of this study was to describe the types of patients who received an ABM service in a community pharmacy in Ontario in 2017. The secondary aim was to describe reimbursable clinical service uptake. Methods: In September 2017, the ABM was implemented across 3 Ontario community pharmacies within a Canadian pharmacy banner. Patients who filled at least 1 chronic oral medication and consented to enrolment were eligible. In December 2018, data were extracted from pharmacies using pharmacy management software. Descriptive statistics and frequencies were generated. Results: Analysis of 131 patients (51.1% female; mean ± SD age 70.8 ± 10.5 years) revealed patients were dispensed a mean ± SD of 5.1 ± 2.7 medications, and 73 (55.7%) experienced polypharmacy. Hypertension (87.8%) and dyslipidemia (68.7%) were the most common medical conditions. There were 74 (56.5%) patients who received ≥1 medication review service (MedsCheck). Of 79 unique drug therapy problems (DTPs) identified, the most common categories related to patients needing additional drug therapy and adverse drug reactions. Discussion and conclusion: Patients enrolled in the ABM were generally older adults experiencing polypharmacy. The ABM presented opportunities for DTP identification and delivery of reimbursed services. Findings support continued exploration of the ABM to support integration of clinical services within community practice.
SARS-CoV-2 seroprevalence screening study of a children’s hospital health care workers
Authors: Pluss Olivia , Berman Stephen , Lamb Molly , Knight Vijaya , Roell Yannik , Berkowitz Steven , Jaenisch Thomas 
Published: April 2024

Background Health care workers (HCWs) are front line responders to the COVID-19 pandemic, but limited data is available for pediatric HCWs, as the research response has largely focused on adult patients and medical personnel that treat these patients. Methods We conducted a cross-sectional study of SARS-CoV-2 seroprevalence and risk factors in HCWs at a Children’s Hospital in CO, USA from September 2020 to April 2021. Pediatric HCWs were defined as clinical care providers and administrative staff. Seroprevalence was determined using the Epitope SARS-CoV-2 anti-Nucleocapsid IgG assay (San Diego, CA) and the Euroimmun SARS-CoV-2 anti-Spike Protein IgG assay. Risk factors and vaccination status were assessed via questionnaire. Results Overall, 110 HCWs were enrolled, 79 subjects were positive for anti-S antibodies and negative for anti-N antibodies, indicating COVID-19 vaccination. 31 subjects had neither anti-N or anti-S antibodies, indicating no exposure to SARS-CoV-2 and no vaccination. 3/110 had a nucleocapsid serology consistent with a SARS-CoV-2 prior infection. Seroprevalence was observed at 2.7%. It was noted that asthma requiring medication was associated with positive serostatus. Conclusions During the winter 2020/21, SARS-CoV-2, we found a 2.7% seroprevalence of pediatric HCW at a children’s hospital in Colorado. We compared this with publicly available seroprevalence data for seroprevalence rates of pediatric HCWs globally. This suggests that this specific children’s hospital COVID-19 personal protective equipment (PPE) and infection control guidelines were effective in limiting SARS-CoV-2 in hospital transmission at the children’s hospital prior to the presence of the Delta variant.