bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can ayahuasca reduce inattention, hyperactivity and impulsivity? A pilot study
Authors: Tsang WaiFung , Ruffell Simon GD , Netzband Nigel , Jong Angelina , Rucker James , Deeley Quinton , Hollingdale Jack 
Published: November 2023

Background The potential benefits of ayahuasca on mental health conditions are well documented. This pilot study is the first to explore whether there is an association with ayahuasca use and reductions in inattention, hyperactivity and impulsivity, the core features of attention-deficit/hyperactivity disorder. Methods In this exploratory, observational pilot study, the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale was administered to 49 adults (23 males, 24 females, two participants did not report their sex) prior to and following the completion of ayahuasca retreats facilitated by the Ayahuasca Foundation in Iquitos, Peru. Only four participants self-reported having a diagnosis of attention-deficit/hyperactivity disorder. Participants attended either an 8-day (four to five ceremonies), 2-week (six ceremonies), 3-week (eight ceremonies) or 4-week (three to 11 ceremonies) retreat. Results Inattention, hyperactivity/impulsivity and total scores significantly reduced following an ayahuasca retreat, irrespective of the length of that retreat and the number of ceremonies participants attended. Conclusions This pilot study is the first to find reductions in self-reported inattention, hyperactivity and impulsivity in a sample of mostly non-attention-deficit/hyperactivity disorder adults following the use of ayahuasca. However controlled trials are required to determine causality. Research and clinical implications are considered.
Investigating the effect of an mHealth coaching intervention on health beliefs, adherence and blood pressure of patients with hypertension: A longitudinal single group pilot study
Authors: Zahed Karim , Markert Carl , Dunn Patrick , Sasangohar Farzan 
Published: November 2023

Background Mobile health technologies have shown promise as delivery platforms for digital health coaching for chronic conditions. However, the impacts of such strategies on users’ health beliefs, intentions and ultimately clinical outcomes are understudied. Objective This study sought (1) to evaluate the effects of a digital health coaching intervention on participants’ belief constructs; and (2) to assess relationships between these belief constructs and intentions to utilize the technological intervention, actual adherence metrics and clinical outcomes related to hypertension. Methods Thirty-four participants with hypertension were recruited from a university community from January to May 2021. They self-measured weight and blood pressure (BP) for 30 days followed by digital coaching delivered via a mobile application for 30 days. Surveys assessed constructs from the Health Belief Model and Technology Acceptance Model, compared to intention, health belief, BP self-monitoring adherence and BP outcomes. A path analysis model was used to assess the relationships between constructs and intention, adherence metrics and clinical outcomes. A Kruskal–Wallis test was used to identify changes in beliefs. Results Participant health beliefs significantly improved after coaching, including self-efficacy ( H(1) = 15.12, p < 0.001), cues to action ( H(1) = 5.33, p =  0.02), attitude ( H(1) = 10.35, p = 0.002), perceived usefulness ( H(1) = 15.02, p < 0.001) and decreased resistance to change ( H(1) = 4.05, p = 0.04). Adherence to BP measurements positively correlated with perceived health threat ( β = .033, p = 0.007) and perceived ease of use ( β = .0277, p < 0.001). Self-efficacy ( β = −2.92, p = 0.02) and perceived usefulness ( β = −3.75, p = 0.01) were linked with a decrease in diastolic BP. Conclusions A mobile health coaching intervention may help participants improve beliefs regarding hypertension self-management.
Effects of Opioid-Limiting Legislation in the State of Ohio on Opioid Prescriptions After Shoulder Arthroscopy
Authors: Strony John T. , Raji Yazdan , Trivedi Nikunj N. , McMellen Christopher J. , Yu Jiao , Calcei Jacob G. , Voos James E. , Gillespie Robert J. 
Published: November 2023

Background: Recent studies have shown that legislation regulating opioid prescriptions in the United States has been successful in reducing the morphine milligram equivalent (MME) prescribed after certain orthopaedic procedures. Purpose: To (1) determine the effect of Ohio’s legislation limiting opioid prescriptions after shoulder arthroscopy and (2) identify risk factors associated with prolonged opioid use and increased postoperative opioid dosing. Study Design: Cohort study; Level of evidence, 3. Methods: We reviewed the data of patients who underwent shoulder arthroscopy between January 1, 2016, and March 31, 2020. Patients were classified according to the date of legislation passage (August 31, 2017) as before legislation (PRE) or on/after legislation (POST). Patients were also classified based on the number of opioid prescriptions filled within 30 days of surgery as opioid-tolerant (at least 1 prescription) or opioid-naïve (zero prescriptions). We recorded patient characteristics, medical comorbidities, and surgical details, as well as the number of opioid prescriptions, MME per prescription from 30 days preoperatively to 90 days postoperatively, and the number of gamma-aminobutyric acid (GABA) analogues and benzodiazepine prescriptions from 30 days preoperatively to the date of surgery. Differences between cohorts were compared with the Fisher exact test and Wilcoxon test. A covariate-adjusted regression analysis was used to evaluate risk factors associated with increased postoperative opioid dosing. Results: Overall, 279 patients (n = 97 PRE; n = 182 POST; n = 42 opioid-tolerant; n = 237 opioid-naïve) were included in the final analysis. There was a significant reduction in the cumulative MME prescribed in the immediate (0-7 days) postoperative period (PRE, 450 MME vs POST, 315 MME), the first 30 postoperative days (PRE, 590 MME vs POST, 375 MME), and the first 90 postoperative days (PRE, 600 MME vs POST, 420 MME) ( P < .001 for all). The opioid-tolerant cohort had higher MME at every time point in the postoperative period ( P < .001). Consumption of preoperative opioid (β = 1682.5; P < .001), benzodiazepine (β = 468.09; P < .001), and GABA analogue (β = 251.37; P = .04) was associated with an increase in the cumulative MME prescribed. Conclusion: Opioid prescription–limiting legislation in Ohio significantly reduced the cumulative MME prescribed in the first 30 days postoperatively for both opioid-naïve and opioid-tolerant patients after shoulder arthroscopy. Consumption of opioids, benzodiazepines, and GABA analogues preoperatively was associated with increased postoperative opioid dosage.
Sleep duration and Framingham´s cardiovascular risk score: results from the Hoveyzeh Cohort Study (HCS)
Authors: Cheraghian Bahman , Heybar Habib , Saki Nader , Raeisizadeh Maedeh , Hashemi Seyed Jalal , Bitaraf Saeid 
Published: November 2023

Abstract
Background
Cardiovascular diseases (CVDs) are the leading causes of global deaths. So, it is necessary to know the possible risk factors for each region. We aimed to assess the relationship between the risk of CVDs and sleep duration in the Iranian Arab population.

Methods
In this cross-sectional study, data from 8362 participants aged between 35 and 70 from the Hoveyzeh Cohort Study enrollment phase between 2016 and 2018 was analyzed. This study evaluated the association between ten-year CVD risk using the Framingham risk score and sleep duration. Self-reported sleep duration was categorized as short duration (equal to or less than 5 h), standard duration (6–8 h), or prolonged duration (equal to or greater than 9 h). Multivariable logistic regression to adjust for conventional CVD risks was used.

Results
Among the assessed participants, 4892 (58.50%) were female, and the mean age was 47.93 (9.01). The average sleep duration was 7.59 (1.56) hours. The low, intermediate-to-high, and high CVD risk individuals were 6461 (77.27%), 1185 (14.17%), and 716 (8.56%), respectively. There was a significant relationship between prolonged sleep duration and lower odds of intermediate-to-high CVD risk in males (OR 0.66, 95% CI: 0.49–0.87, P-value: 0.004).

Conclusion
The results of our study showed that longer sleep duration has a protective association with the intermediate to high risk of cardiovascular diseases in males. However, long and short sleep durations have no significant relationship with females’ risk of cardiovascular disease.
Tumor segmentation via enhanced area growth algorithm for lung CT images
Authors: Khorshidi Abdollah 
Published: November 2023

Abstract
Background
Since lung tumors are in dynamic conditions, the study of tumor growth and its changes is of great importance in primary diagnosis.

Methods
Enhanced area growth (EAG) algorithm is introduced to segment the lung tumor in 2D and 3D modes on 60 patients CT images from four different databases by MATLAB software. The contrast augmentation, color intensity and maximum primary tumor radius determination, thresholding, start and neighbor points’ designation in an array, and then modifying the points in the braid on average are the early steps of the proposed algorithm. To determine the new tumor boundaries, the maximum distance from the color-intensity center point of the primary tumor to the modified points is appointed via considering a larger target region and new threshold. The tumor center is divided into different subsections and then all previous stages are repeated from new designated points to define diverse boundaries for the tumor. An interpolation between these boundaries creates a new tumor boundary. The intersections with the tumor boundaries are firmed for edge correction phase, after drawing diverse lines from the tumor center at relevant angles. Each of the new regions is annexed to the core region to achieve a segmented tumor surface by meeting certain conditions.

Results
The multipoint-growth-starting-point grouping fashioned a desired consequence in the precise delineation of the tumor. The proposed algorithm enhanced tumor identification by more than 16% with a reasonable accuracy acceptance rate. At the same time, it largely assurances the independence of the last outcome from the starting point. By significance difference of p < 0.05, the dice coefficients were 0.80 ± 0.02 and 0.92 ± 0.03, respectively, for primary and enhanced algorithms. Lung area determination alongside automatic thresholding and also starting from several points along with edge improvement may reduce human errors in radiologists’ interpretation of tumor areas and selection of the algorithm’s starting point.

Conclusions
The proposed algorithm enhanced tumor detection by more than 18% with a sufficient acceptance ratio of accuracy. Since the enhanced algorithm is independent of matrix size and image thickness, it is very likely that it can be easily applied to other contiguous tumor images.

Trial registration
PAZHOUHAN, PAZHOUHAN98000032. Registered 4 January 2021, http://pazhouhan.gerums.ac.ir/webreclist/view.action?webreclist_code=19300
Hospitalizations for congenital syphilis in children under one year old in the state of Pará, Brazilian Amazon: ecological study
Authors: Neri Débora Talitha , da Costa Miranda Amanda Loyse , Botelho Eliã Pinheiro , Valois Rubenilson Caldas , Dias Geyse Aline Rodrigues , Parente Andressa Tavares , da Cunha Araújo Eliete , Ferreira Glenda Roberta Oliveira Naiff 
Published: November 2023

Abstract
Background
The high incidence of congenital syphilis shows flaws in the resolution of primary health care, being a predictor of greater use of hospital services, whose regional differences in access to health actions and services may be reflected in health inequalities.

Objective
to investigate hospitalizations due to congenital syphilis in children under one year of age, in the state of Pará, Brazilian Amazon.

Methods
an ecological study was carried out, using hospitalization, lethality and mortality rates related to congenital syphilis in children under one year of age. Temporal analysis and mapping of hospitalization flows were carried out using Joinpoint®, version 4.7.0.0, Terraview 4.2.2, Tabwin 4.1.5.

Results
A total of 6,487 hospitalizations were recorded. For the ten years of the study period (2009 to 2018), the lethality rate showed a decreasing trend of – 13.5% (p = 0.01). The crude hospitalization rate showed an increasing trend of 12.8% (p < 0.000. The regression analysis demonstrated that there was a change point in the trend with a significant growth of 12.8% until 2016 (p = 0.0006). In the mortality rate the trend was stable (p = 0.56). The analysis of hospitalization care flows made it possible to identify that most hospitalizations due to congenital syphilis occurred in the municipalities of residence, but 1,378 (21.2%) had to move. Two large care gaps were highlighted in Metropolitan health regions II and III, belonging to macroregion II. The hospitalizations of residents of these regions were carried out by the assistance networks of Belém (capital) and Marituba, both of which are part of Metropolitana I. Residents of macroregions III and IV had the greatest distances traveled to access hospital care.

Conclusions
The increase in the rate of hospitalizations with an increasing trend demonstrates the impact that syphilis still causes in Brazil, not being resolved even after national government interventions in primary health care, but there was a decreasing trend in the fatality rate. The results demonstrate a heterogeneous organization of health care networks in the state’s health regions and macroregions.
Association between diet soft drink consumption and metabolic dysfunction-associated steatotic liver disease: findings from the NHANES
Authors: Wu Yanrui , Tan Zongbiao , Zhen Junhai , Liu Chuan , Zhang Jixiang , Liao Fei , Dong Weiguo 
Published: November 2023

Abstract
Background
Lifestyle change plays a crucial role in the prevention and treatment of metabolic dysfunction-associated steatotic liver disease (MASLD). In recent years, diet soft drinks that emphasize “zero sugar and zero calories” have become all the rage, but whether diet soft drink consumption is associated with MASLD is not clear.

Methods
This study included data from the National Health and Nutrition Examination Surveys (NHANES) in 2003–2006. The assessment of MASLD status primarily relied on the Fatty Liver Index (FLI). Weighted multiple Logistic regression models were constructed to evaluate the association between diet soft drink consumption and MASLD. Additionally, mediation analysis was performed to examine the mediating effect of body mass index (BMI).

Results
A total of 2,378 participants were included in the study, among which 1,089 individuals had MASLD, and the weighted prevalence rate was 43.64%. After adjusting for variables related to demographic, lifestyle, and metabolic syndrome, excessive diet soft drink consumption (the “always” frequency) remained significantly associated with the occurrence of MASLD (OR = 1.98, 95%CI = 1.36–2.89, P = 0.003). It was estimated that 84.7% of the total association between diet soft drink consumption and MASLD was mediated by BMI (P < 0.001).

Conclusions
Excessive diet soft drink consumption was associated with the occurrence of MASLD. BMI may play a mediating role in the association between diet soft drink consumption and MASLD.
Association of systemic immune-inflammation index (SII) and aggregate index of systemic inflammation (AISI) with thyroid nodules in patients with type 2 diabetes mellitus: a retrospective study
Authors: Cao Can , Li Chunyao , Li Xiaoting , Sun Weiwei , Wang Yaoxian 
Published: November 2023

Abstract
Objective
This retrospective study aimed to investigate the association between TNs and the systemic immune-inflammation index (SII) and the aggregate index of systemic inflammation (AISI) in patients with T2DM.

Methods
A total of 370 T2DM patients, who were admitted to Dongzhimen Hospital between January 2020 and March 2023, were included in this retrospective study. Binary logistic regression models with multivariable adjustment were employed to assess the relationship between SII, AISI quartiles, and TNs. Furthermore, receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic accuracy of SII and AISI in identifying T2DM patients with TNs.

Results
Age, diabetes duration, diabetic nephropathy (DN), SII, and AISI demonstrated significant positive associations with TNs. Compared to the first quartile of SII, the second, third, and fourth quartiles showed increased risks of TNs with hazard ratios (HRs) of 1.578 (0.883–2.820), 2.279 (1.257–4.131), and 3.626 (1.931–6.810), respectively (P < 0.001). Similar results were observed for AISI and TNs. ROC curve analysis revealed that SII and AISI exhibited a high discriminatory capability for identifying TNs in the overall and male participant group, whereas the significance among females was not discernible.

Conclusions
This study provides evidence that SII and AISI are independent risk factors for TNs, suggesting that elevated SII and AISI levels may contribute to the development of TNs in patients with T2DM particularly among male individuals.
Assessing the competency of pharmacists in writing effective curriculum vitae for job applications: a cross-sectional study and readability index evaluation
Authors: Odeh Mohanad , Oqal Muna , AlDroubi Hanan , Al-Omari Basem 
Published: November 2023

Abstract
Background
In today’s competitive job market, pharmacists must have a well-crafted curriculum vitae (CV), cover letter, and personal statement. However, non-native English speakers may face challenges in crafting effective job application documents. Jordan is one such country where English is a second language for many, and little is known about the CV/job application writing skills of Jordanian pharmacists. Therefore, this study examined Jordanian pharmacists’ ability to write job applications cover letters, and personal statements in English and investigated the association between several demographics and professional variables and the readability index of cover letters and personal statements.

Methods
This study aimed to investigate Jordanian pharmacists’ ability to write job applications cover letters, and personal statements in English and evaluate the readability of their personal statements and cover letters. The data were blindly and independently reviewed by two researchers. The readability of the cover letters and personal statements was assessed using an online calculator that assigns a readability index score. A readability score of 7–12 was considered “target”, while scores above 12 or below 7 were considered “complicated” or “simple”, respectively. The relationship between readability index scores and other variables was analyzed using the chi-square test with a statistical significance level of 0.05.

Results
The study recruited 592 pharmacists. Most applicants, specifically 62.3%, were female, and 60.0% of them graduated more than six months before submitting their job applications. While 78.2% of the applications included a personal statement, only 34.8% included a cover letter, and 27.2% provided both. Of the 206 cover letters written in English, 43.2% were tailored, and 80.6% were structured. The study also found that the provision of an official photo was associated with providing a cover letter (P < 0.001, Phi(φ) = 0.14) while providing a structured cover letter was associated with including a personal statement (P < 0.001, Phi (φ) = 0.24). Only 102 cover letters and 65 personal statements had readability index scores within the target range.

Conclusion
In this study, most Jordanian pharmacists undervalue the importance of cover letters and personal statements and lack job application writing skills. The study also highlighted the need for improved pharmacists’ English proficiency to write effective job application documents in Jordan.
Interpretable prediction of 3-year all-cause mortality in patients with chronic heart failure based on machine learning
Authors: Xu Chenggong , Li Hongxia , Yang Jianping , Peng Yunzhu , Cai Hongyan , Zhou Jing , Gu Wenyi , Chen Lixing 
Published: November 2023

Abstract
Background
The goal of this study was to assess the effectiveness of machine learning models and create an interpretable machine learning model that adequately explained 3-year all-cause mortality in patients with chronic heart failure.

Methods
The data in this paper were selected from patients with chronic heart failure who were hospitalized at the First Affiliated Hospital of Kunming Medical University, from 2017 to 2019 with cardiac function class III-IV. The dataset was explored using six different machine learning models, including logistic regression, naive Bayes, random forest classifier, extreme gradient boost, K-nearest neighbor, and decision tree. Finally, interpretable methods based on machine learning, such as SHAP value, permutation importance, and partial dependence plots, were used to estimate the 3-year all-cause mortality risk and produce individual interpretations of the model's conclusions.

Result
In this paper, random forest was identified as the optimal aools lgorithm for this dataset. We also incorporated relevant machine learning interpretable tand techniques to improve disease prognosis, including permutation importance, PDP plots and SHAP values for analysis. From this study, we can see that the number of hospitalizations, age, glomerular filtration rate, BNP, NYHA cardiac function classification, lymphocyte absolute value, serum albumin, hemoglobin, total cholesterol, pulmonary artery systolic pressure and so on were important for providing an optimal risk assessment and were important predictive factors of chronic heart failure.

Conclusion
The machine learning-based cardiovascular risk models could be used to accurately assess and stratify the 3-year risk of all-cause mortality among CHF patients. Machine learning in combination with permutation importance, PDP plots, and the SHAP value could offer a clear explanation of individual risk prediction and give doctors an intuitive knowledge of the functions of important model components.