bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacokinetic effect of disease severity and use of extracorporeal membrane oxygenation in critically ill Asian patients receiving vancomycin
Authors: Avachat Charul , Hung Pi-lien , Birnbaum Angela K. , Healy Daniel P. , Sherwin Catherine M. , Lin Alex C. 
Published: February 2025

PurposeVancomycin is an essential antibiotic for the treatment of severe gram-positive bacterial infections, including methicillin-resistant Staphylococcus aureus (MRSA). In critically ill patients, particularly children, attaining the appropriate dosage is crucial to avert drug resistance and ensure therapeutic efficacy. This study sought to investigate the pharmacokinetics of vancomycin in critically ill Asian pediatric patients and evaluate the influence of extracorporeal membrane oxygenation (ECMO) and disease severity on vancomycin clearance.MethodsThis retrospective analysis examined data from 90 critically ill Asian patients residing in Kaohsiung, Taiwan, encompassing 263 data points gathered over 2 years. A one-compartment pharmacokinetic model with first-order elimination was constructed using nonlinear mixed-effects modeling to assess the impact of ECMO and infection severity on vancomycin clearance.ResultsThe pharmacokinetics of vancomycin were markedly affected by ECMO and the severity of the illness. Patients using ECMO demonstrated a 56% decrease in vancomycin clearance relative to non-ECMO patients. Furthermore, patients with milder infections (e.g., cellulitis, surgical prophylaxis, neutropenic fever) had a 39% decrease in vancomycin clearance relative to those with more severe infections (e.g., pneumonia, bacteremia, osteomyelitis, meningitis, deep tissue infection).ConclusionThe study demonstrates that ECMO and infection severity are major factors influencing vancomycin clearance in critically unwell pediatric patients. The significant decrease in clearance linked to ECMO and reduced infection severity underscores the necessity for meticulous therapeutic drug monitoring and tailored dosing strategies to enhance vancomycin treatment in this at-risk population. The findings highlight the significant interindividual diversity in vancomycin pharmacokinetics in critically unwell pediatric patients.
High-performance PBPK model for predicting CYP3A4 induction-mediated drug interactions: a refined and validated approach
Authors: Yang Cheng-Guang , Chen Tao , Si Wen-Teng , Wang An-Hai , Ren Hong-Can , Wang Li 
Published: February 2025

IntroductionThe cytochrome P450 enzyme 3A4 (CYP3A4) mediates numerous drug-drug interactions (DDIs) by inducing the metabolism of co-administered drugs, which can result in reduced therapeutic efficacy or increased toxicity. This study developed and validated a Physiologically Based Pharmacokinetic (PBPK) model to predict CYP3A4 induction-mediated DDIs, focusing on the early stages of clinical drug development.MethodsThe PBPK model for rifampicin, a potent CYP3A4 inducer, was developed and validated using human pharmacokinetic data. Subsequently, PBPK models for ‘victim’ drugs were constructed and validated. The PBPK-DDI model’s predictive performance was assessed by comparing predicted area under the curve (AUC) and maximum concentration (Cmax) ratioswith empirical data, using both the 0.5 to 2-fold criterion and theGuest criteria.ResultsThe rifampicin PBPK model accurately simulated human pharmacokinetic profiles. The PBPK-DDI model demonstrated high predictive accuracy for AUC ratios, with 89% of predictions within the 0.5 to 2-fold criterion and 79% meeting the Guest criteria. For Cmax ratios, an impressive 93% of predictions were within the acceptable range. The model significantly outperformed the static model, particularly in estimating DDI risks associated with CYP3A4 induction.DiscussionThe PBPK-DDI model is a reliable tool for predicting CYP3A4 induction-mediated DDIs. Its high predictive accuracy, confirmed by adherence to evaluation standards, affirms its reliability for drug development and clinical pharmacology. Future refinements may further enhance its predictive value.
Impact of different doses of cold water immersion (duration and temperature variations) on recovery from acute exercise-induced muscle damage: a network meta-analysis
Authors: Wang Hai , Wang Lu , Pan Yingxu 
Published: February 2025

ObjectiveThis network meta-analysis and systematic review evaluated the recovery impacts of varying cold water immersion (CWI) protocols on acute exercise-induced muscle damage.MethodsWe searched CNKI, PubMed, Cochrane Library, Web of Science, and Embase from January 2000 to September 2024 for randomized controlled trials examining CWI’s recovery effects on acute muscle damage. Data extraction, study screening, and risk of bias assessment were conducted independently by two reviewers. Analyses were performed using Stata 16.0.ResultsA total of 55 RCTs were included, with 42 reporting delayed onset muscle soreness (DOMS), 36 reporting jump performance (JUMP), and 30 reporting creatine kinase (CK) levels. Network meta-analysis showed that compared with the control group, MD-MT-CWI: Medium-duration medium-temperature cold water immersion (10–15 min, 11°C–15°C) [SMD = −1.45, 95%CI(-2.13, −0.77), P &lt; 0.01] and MD-LT-CWI: Medium-duration low-temperature cold water immersion (10–15 min, 5°C–10°C) [SMD = −1.12, 95%CI(-1.78, −0.47), P = 0.01] significantly reduced DOMS; MD-LT-CWI (10–15 min, 5°C–10°C) [SMD = 0.48, 95%CI(0.20, 0.77), P = 0.01] and MD-MT-CWI (10–15 min, 11°C–15°C) [SMD = 0.42, 95%CI(0.15, 0.70), P = 0.02] significantly improved JUMP; MD-MT-CWI (10–15 min, 11°C–15°C) [SMD = −0.85, 95%CI(-1.36, −0.35), P = 0.01] and MD-LT-CWI (10–15 min, 5°C–10°C) [SMD = −0.90, 95%CI(-1.46, −0.34), P = 0.02] significantly reduced CK. Cumulative probability ranking showed that MD-LT-CWI (10–15 min, 5°C–10°C) was the most effective for improving JUMP and reducing CK, while MD-MT-CWI (10–15 min, 11°C–15°C) was the most effective for reducing DOMS.ConclusionDifferent dosages of cold water immersion (varying in duration and temperature) had different effects on recovery from acute exercise-induced muscle damage. We found that MD-LT-CWI (10–15 min, 5°C–10°C) was most effective for improving biochemical markers (CK) and neuromuscular recovery, while MD-MT-CWI (10–15 min, 11°C–15°C) was most effective for reducing muscle soreness. In practice, we recommend using MD-LT-CWI (10–15 min, 5°C–10°C) and MD-MT-CWI (10–15 min, 11°C–15°C) to reduce Exercise-induced muscle damage (EIMD). However, due to the limitations of the included studies, further high-quality studies are needed to verify these conclusions.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024602359.
Burnout, life satisfaction, and work-related quality of life among psychologists
Authors: Santana Ferreira Silvia Morais de , Zaia Victor 
Published: February 2025

IntroductionThe Work-Related Quality of Life (WRQoL) is a complex, multidimensional concept, and its assessment is challenging due to a lack of consensus on the factors involved. While the WRQoL Scale has been validated in various countries, no translation into Brazilian Portuguese existed until this study. The primary aim was to validate the Brazilian Portuguese version of the WRQoL Scale, using psychologists as the target population, and to measure burnout and life satisfaction in this group.MethodsA backtranslation process was followed, involving bilingual translators and a focus group of psychology professionals to refine the final version. A total of 610 psychologists participated, completing the Maslach Burnout Inventory, the Life Satisfaction Scale, and the WRQoL Scale via an online platform (SurveyMonkey®). Exploratory and confirmatory factor analyses were conducted to test and refine the factor structure of the WRQoL Scale. Spearman's correlations and group comparison analyses were also performed.ResultsSeventy-six percentage of participants reported adequate life satisfaction, while 60.2% exhibited burnout symptoms, particularly in emotional exhaustion and depersonalization. Protective factors for the mental health of psychologists were identified. The final version of the WRQoL Scale included 23 items across three factors, with good internal consistency (Cronbach's alpha = 0.89 ICC = 0.96).DiscussionThe WRQoL Scale - Brazilian version, demonstrated adequate psychometric properties, as evidenced by its construct validity and internal consistency. This provides evidence that the WRQoL Scale is a adequate tool that can measure work-related quality of life in psychologists.
Stigma and self-perceived burden in postoperative liver cancer patients: the mediating role of financial toxicity
Authors: Zhang Yue , Cao Yiqin , Wang Yanyan , Wang Di , Ye Hongfang , Nie Chunlei 
Published: February 2025

PurposeTo investigate the mediating effect of financial toxicity on stigma and self-perceived burden in patients with liver cancer after surgery.MethodsUsing a convenience sampling method, 236 postoperative liver cancer patients treated at a tertiary hospital in Nanjing from April 2024 to July 2024 were selected for the study. Questionnaires were administered, including a general information survey, the Social Impact Scale (SIS), the Self-Perceived Burden Scale for Cancer Patients (SPBS-CP), and the Comprehensive Score for Financial Toxicity-Functional Assessment of Chronic Illness Therapy Version 2 (COST-FACIT-V2). Data were analyzed using SPSS 22.0 for descriptive statistics, correlation analysis, and regression analysis. MPlus 8.3 was employed to examine the mediating effect of financial toxicity between stigma and self-perceived burden, and the Bootstrap method was used to test the significance of the mediation effect.ResultsThe self-perceived burden score, stigma score, and financial toxicity score were (31.72 ± 7.52), (58.92 ± 8.69), and (18.62 ± 6.80), respectively. The financial toxicity and self-perceived burden were negatively correlated (r=−0.270,P=0.001). There was a positive correlation between stigma and self-perceived burden (r=0.586,P=0.000). Financial toxicity partially mediated the relationship between stigma and self-perceived burden, accounting for 4.84% of the total effect.ConclusionStigma can influence the self-perceived burden of liver cancer patients through financial toxicity. Clinical nurses should prioritize alleviating patients’ stigma while also paying close attention to their financial toxicity status, providing feasible assistance in a timely manner to reduce their self-perceived burden.
The relationship of body image with sexual dysfunction and dyadic adjustment in individuals diagnosed with bipolar disorder in Türkiye
Authors: Yazar Emine Reyhan , İzci Filiz 
Published: February 2025

IntroductionThe objective of this study is to evaluate the relationship of body image (BI) with sexual dysfunction (SD) and dyadic adjustment (DA) in individuals diagnosed with Bipolar Disorder (BD). Dyadic adjustment has been defined as a dynamic process determined by variables such as relationship differences, interpersonal tensions and personal concerns, relationship satisfaction, and couple consensus. In this context, it was specifically aimed to determine the link between these factors and quality of life (QoL) in individuals with BD based on the effects of BI on sexual function and marital adjustment.MethodsThis study was conducted in a psychiatric hospital in Turkiye. The population of this cross-sectional, single-center study consisted of 110 individuals who applied to the outpatient clinics of Istanbul Erenköy Mental Health and Neurological Diseases Training and Research Hospital between March 2020 and August 2020. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)Disorders-Clinician Version (SCID-5-CV), sociodemographic and clinical data form, Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D), Golombok-Rust Inventory of Sexual Satisfaction (GRISS), Dyadic Adjustment Scale (DAS), Body Image Scale (BIS) and the Brief Quality of Life in Bipolar Disorder (Brief QoL.BD) Questionnaire were used to collect the research data.ResultsThe study sample consisted of 80 individuals, 50 females and 30 males, who were diagnosed with BD and were in remission. The rate of SD in individuals with BD was found to be 55%. The most common SD was vaginismus in female individuals with BD and premature ejaculation in male individuals with BD. It has been observed that SD negatively affected DA in individuals with BD. On the other hand, no significant relationship was found between body mass index (BMI) and BI or between BI and SD in individuals with BD. However, increased satisfaction with BI positively affected DA and QoL.DiscussionThe study’s findings indicated a significant relationship between sexual satisfaction, marital adjustment, BI, and QoL in individuals with BD. While no significant change was observed in DA in male individuals with BD, it was found that sexual satisfaction decreased as DA deteriorated in female individuals with BD. Additionally, it was found that BI affected DA in individuals with BD but not sexual satisfaction. Lastly, no significant relationship was observed between BMI and BI, DA, or QoL.
Explore autophagy-related lncRNA-miRNA-mRNA ceRNA networks for diagnosis of early-onset schizophrenia through transcriptome analysis
Authors: Hu Wei , Du Xinzhe , Wang Xinxia , Zhang Kexin , Li Junxia , Gao Yao , An Ting , Zhang Hong , Zhang Yu , Ren Zhiyong , Xu Yong , Liu Sha 
Published: February 2025

BackgroundThe severe functional impairment and poor prognosis of early-onset schizophrenia (EOS) create a great need to identify effective biomarkers for early diagnosis in young psychiatric patients. Current research indicates a potential link between loss of autophagy function and emotional and behavioral abnormalities in individuals with psychiatric disorders.Materials and MethodsThis study aimed to explore diagnostic autophagy-related endogenous competitive RNA (ceRNA) networks for EOS patients. The messenger RNAs (mRNAs) and long non-coding RNAs (lncRNAs) expression profiles were obtained from peripheral blood mononuclear cells of 18 EOS patients and 12 healthy controls (HC). A co-expression analysis was performed between 365 core lncRNAs and 55 differentially expressed autophagy-related genes (ARGs) to identify differentially expressed autophagy-related lncRNAs. Subsequently, five diagnostic autophagy-related lncRNAs were identified as candidate genes to construct a ceRNA regulatory network using least absolute shrinkage and selection operator (LASSO) Cox regression, and receiver operating characteristic (ROC) curve analysis was performed to evaluate their predictive accuracy. Then, putative interactions among lncRNA-microRNAs (miRNAs)-mRNA were determined based on the lncRNASNP2 and TarBase databases.ResultsThree lncRNAs, twenty miRNAs, and ten mRNAs were selected to construct an autophagy-associated ceRNA network associated with EOS occurrence. Through protein-protein interaction network analysis, five hub mRNAs were identified, which exhibited good predictive ability in distinguishing EOS patients from healthy individuals. ROC curve analysis demonstrated that integrating three diagnostic lncRNAs (RP1-135L22.1, RP5-884C9.2, RP11-390F4.3) along with five hub mRNAs (EIF4G1, AKT1, BAX, WIPI2, MAPT) appeared to yield better diagnostic accuracy compared to using either lncRNAs or mRNAs alone. Furthermore, all three diagnostic lncRNAs and five hub mRNAs were positively correlated with at least two types of immune infiltration.ConclusionThrough transcriptome analysis, we searched for diagnostic autophagy-related ceRNA networks, which provided valuable candidates for the early diagnosis of EOS.
Multimorbidity characteristics in older adults and their associated factors in complex networks: a cross-sectional study
Authors: Wu Dan , Xu Jiani , Zhang Haibo , Zhang Kai , Zhu Yongqian 
Published: February 2025

BackgroundMultimorbidity of chronic diseases has become an increasingly serious public health problem. However, the research on the current situation of multimorbidity in the older adults in Jiangsu, China is relatively lacking.MethodsWe surveyed a total of 229,926 inpatients aged above 60 and with two or more chronic diseases in the First Affiliated Hospital with Nanjing Medical University from January 1, 2015 to December 31, 2021. The Apriori algorithm was used to analyze the association rules of the multimorbidity patterns in old adults.ResultsThe mean age of these patients was 72.0 ± 8.7 years, and the male-to-female ratio was 1: 1.53. These patients during the COVID-19 period (from 2020 to 2021) displayed younger, higher male rate, shorter median length of hospital stay, higher ≥6 multimorbidities rate and lower median cost than those not during the COVID-19 period (from 2015 to 2019). In all of these patients, the top 5 chronic diseases were “Hypertensive diseases (I10-I15),” “Other forms of heart disease (I30-I52),” “Diabetes mellitus (E10-E14),” “ischaemic heart diseases (I20-I25)” and “Cerebrovascular diseases (I60-I69).” The complex networks of multimorbidity showed that Hypertensive diseases had a higher probability of co-occurrence with multiple diseases in all these patients, followed by diabetes mellitus, other forms of heart disease, and ischaemic heart diseases (I20-I25).ConclusionIn conclusion, the patterns of multimorbidity among the aged varied by COVID-19. Our results highlighted the importance of control of hypertensive diseases, diabetes, and heart disease in most periods. However, during the pandemic period, we should pay more attention to diseases that require urgent treatment, such as malignant tumors. For different periods, the spectrum of diseases we focus on should change accordingly.
Social vulnerability and asthma-related emergency medical services in Illinois
Authors: Geiger Sarah Dee , Khaium M. Omar , Gustafson Evan M. , Shapiro Marcus , Keeley Sarah , Johnson Cassandra , Amerson Nancy , Lee Daniel , Gerald Lynn B. , Keddie Arlene 
Published: February 2025

IntroductionThis ecologic study explores the relationship between the Social Vulnerability Index (SVI) and probable asthma-related emergency medical service (EMS) rates before and during the COVID-19 pandemic at the county level in Illinois.MethodsThe number of asthma-related EMS visits was obtained in all 102 counties for adults aged 18 years or more, and for 82 of these counties for children aged less than 18 from 2018 to 2021. They were converted into rates and examined in relation to SVI rankings. Pearson’s correlation coefficients and negative binomial regression were used to examine associations, adjusting for the level of rurality.ResultsThe rate of asthma-related EMS visits increased in adults from 23.1 to 28.9 per 1,000 between 2018 and 2021 but decreased in children from 5.9 to 5 per 1,000. Every 1% increase in the overall SVI was associated with a nearly two-fold increase in the rate of EMS visits in adults (pre-COVID-19: IRR = 1.94, p &lt; 0.01; during-COVID: IRR = 1.90, p &lt; 0.01) and an even greater increase in children (pre-COVID-19: IRR = 2.61, p &lt; 0.01; during-COVID: IRR = 2.92, p &lt; 0.01) Consistent associations were found for the SVI themes of socioeconomic status, housing type, and transportation across age groups and time periods.DiscussionDuring the pandemic, all four themes of SVI were associated with the asthma EMS rate in children. This study has shown that the same factors that lead to community vulnerability in a disaster align with a greater need for on-site asthma emergency treatment.
Examining how fiscal policies influence innovation in TCM enterprises: the role of R&D investment and executives with pharmaceutical backgrounds
Authors: Guo Dan , Qi Liwen , Song Xiaoting 
Published: February 2025

IntroductionInnovation is crucial to realize the modernization and industrialization of traditional Chinese medicine (TCM), so its incentive methods and influence mechanisms are worth exploring. Based on externality theory and imprinting theory, this paper demonstrates the significance of external support and internal resources in the innovation of TCM enterprises.MethodsThis study adopts a sample of listed TCM enterprises in China during 2007–2023 to examine the impacts and differences between innovation subsidies and tax incentives on TCM enterprise innovation. Innovation in TCM enterprises is deconstructed into five dimensions, including innovation quantity (InNum), innovation quality (InQua), substantive innovation (SubIn), strategic innovation (StrIn), and inheritance innovation (InhIn).ResultsIt is found that the incentive effect of innovation subsidies on other dimensions of innovation in TCM firms is generally stronger than that of tax incentives, except for strategic innovation. Heterogeneity analysis indicates that the promoting effect of tax incentives is more significant in the southern TCM production region. Moreover, R&amp;D investment mediates the relationship between innovation subsidies and innovation of TCM enterprises. Furthermore, executives with pharmaceutical backgrounds (EPB) strengthen the impact of innovation subsidies on innovation in various dimensions of TCM enterprises, while EPB only strengthens the impact of tax incentives on innovation quality and substantive innovation.DiscussionThe findings provide new insights for government and TCM enterprises to promote innovation.
Bridging accessibility gaps in urban community-based basic older adult care: a comprehensive framework validated in Xi’an, China
Authors: Zhang Yuyuan , Zhou Ming , Hu Jinrong , Wang Ruoying 
Published: February 2025

ObjectivesAccessibility is a critical factor in ensuring equitable public services. In urban older adult care systems, resource allocation and service disparities present unique challenges. The classical “5A” theory—availability, accessibility, affordability, adaptability, and acceptability—provides a robust framework for evaluating service delivery. However, its application in urban older adult care, especially in rapidly aging societies like China, remains limited. This study aims to develop and validate a framework to address affordability, resource allocation, and service mismatches in urban older adult care systems.MethodsA web-based cross-sectional study was performed in 2023. A multi-phase methodology was adopted to construct the framework, grounded in the “5A” theory. Indicators were refined through expert consultations using the Delphi method, involving 20 experts, while the entropy weight method ensured objective indicator weighting. The framework was empirically validated in Xi’an, China, using survey data collected from 438 older adult residents across urban strata. A fuzzy comprehensive evaluation (FCE) method was employed to assess accessibility and identify key service gaps.ResultsThis study constructs a comprehensive evaluation framework for basic older adult care services (BECS), structured around 5 primary dimensions, 14 sary indicators, and 37 tertiary indicators. Empirical validation in Xi’an further demonstrates the framework’s scientific rigor and practical applicability. While the framework identifies strong spatial accessibility (3.8815), it also reveals critical gaps in affordability (3.1347) and psychological care (3.0862), confirming its effectiveness in diagnosing systemic disparities and guiding policy interventions.ConclusionThis study introduces a novel accessibility evaluation framework tailored for basic older adult care services, addressing critical gaps in affordability, psychological care, and service responsiveness. Empirical results validate the framework’s practicality and its alignment with the real-world conditions of urban aging societies. Furthermore, an innovative “Matching-Realization-Satisfaction” improvement pathway is proposed, offering actionable strategies to enhance accessibility and optimize service delivery. This framework serves as a replicable model for advancing equitable older adult care in rapidly aging urban communities.