bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating the Effect of Ginger as an Adjunctive Treatment along with SSRIs to Reduce Anxiety in Patients with GAD: A Clinical Trial Study
Authors: Ataei Sara , Jahangard Leila , Anaraki Sina , Dastan Dara , Khazaei Salman 
Published: November 2023

Introduction:
Generalized anxiety disorder (GAD) is characterized by exaggerated
anxiety without any apparent cause of concern. The primary treatment of this disorder
is usually SSRIs, which have many digestive side effects and do not provide complete
treatment for the patient. The use of non-pharmacological methods may help reduce these
complications. Therefore, the present study was conducted to investigate the effect of ginger
as an adjunctive therapy along with SSRIs to reduce anxiety in patients with GAD.

Materials and Methods:
In this double-blind, controlled clinical trial study, a total of 80
patients with GAD were randomly assigned into two groups. For the intervention group, at
the same time as SSRI drug, two 500-mg ginger capsules were used daily while in the control
group, two starch capsules were used daily as a placebo along with SSRI. Data collection
tools were Hamilton's anxiety questionnaire and a gastrointestinal symptom severity
scale. Data were collected before the intervention and after the 12-week intervention.

Results:
There was no significant difference between the intervention and control groups
in terms of average anxiety and severity of digestive symptoms before the intervention (p >
0.05), but there was a significant difference between the groups after the intervention (p <
0.05). Also, the average scores of anxiety and severity of gastrointestinal symptoms in the
intervention group increased significantly from the beginning of the intervention to the
follow-up (intragroup difference) (p < 0.05).

Conclusion:
The results of the study showed that the use of ginger along with SSRIs reduced
anxiety and released the severity of gastrointestinal symptoms in patients with
GAD. In addition, in this study, it was found that ginger, along with SSRIs, can have beneficial
effects on indigestion, diarrhea, and nausea in patients with GAD. However, these
findings require more extensive research.
Effects of User-Reported Risk Factors and Follow-Up Care Activities on Satisfaction With a COVID-19 Chatbot: Cross-Sectional Study
Authors: Singh Akanksha , Schooley Benjamin , Patel Nitin 
Published: November 2023

Background
The COVID-19 pandemic influenced many to consider methods to reduce human contact and ease the burden placed on health care workers. Conversational agents or chatbots are a set of technologies that may aid with these challenges. They may provide useful interactions for users, potentially reducing the health care worker burden while increasing user satisfaction. Research aims to understand these potential impacts of chatbots and conversational recommender systems and their associated design features.

Objective
The objective of this study was to evaluate user perceptions of the helpfulness of an artificial intelligence chatbot that was offered free to the public in response to COVID-19. The chatbot engaged patients and provided educational information and the opportunity to report symptoms, understand personal risks, and receive referrals for care.

Methods
A cross-sectional study design was used to analyze 82,222 chats collected from patients in South Carolina seeking services from the Prisma Health system. Chi-square tests and multinomial logistic regression analyses were conducted to assess the relationship between reported risk factors and perceived chat helpfulness using chats started between April 24, 2020, and April 21, 2022.

Results
A total of 82,222 chat series were started with at least one question or response on record; 53,805 symptom checker questions with at least one COVID-19–related activity series were completed, with 5191 individuals clicking further to receive a virtual video visit and 2215 clicking further to make an appointment with a local physician. Patients who were aged >65 years (P<.001), reported comorbidities (P<.001), had been in contact with a person with COVID-19 in the last 14 days (P<.001), and responded to symptom checker questions that placed them at a higher risk of COVID-19 (P<.001) were 1.8 times more likely to report the chat as helpful than those who reported lower risk factors. Users who engaged with the chatbot to conduct a series of activities were more likely to find the chat helpful (P<.001), including seeking COVID-19 information (3.97-4.07 times), in-person appointments (2.46-1.99 times), telehealth appointments with a nearby provider (2.48-1.9 times), or vaccination (2.9-3.85 times) compared with those who did not perform any of these activities.

Conclusions
Chatbots that are designed to target high-risk user groups and provide relevant actionable items may be perceived as a helpful approach to early contact with the health system for assessing communicable disease symptoms and follow-up care options at home before virtual or in-person contact with health care providers. The results identified and validated significant design factors for conversational recommender systems, including triangulating a high-risk target user population and providing relevant actionable items for users to choose from as part of user engagement.
Impact of Remote Patient Monitoring Platform on Patients With Moderate to Severe Persistent Asthma: Observational Study
Authors: Reid Denzil , Mehta Jyotsna , Anis Karim , Mehta Shail 
Published: November 2023

Background
Asthma is one of the most common respiratory diseases, with an ever-growing health care burden. Remote patient monitoring (RPM) has gained increasing importance in the respiratory care area with the outbreak of the COVID-19 pandemic. In this pilot study, we introduced a novel platform that remotely monitors patients with chronic respiratory illnesses using Centers for Disease Control and Prevention guidelines to reduce hospitalizations and emergency department visits.

Objective
This study aimed to understand patient and physician engagement with a new virtual care solution (KevaTalk app and Keva365 platform) and the value, for both patients and providers, of using an RPM tool. We assessed real-world use of the platform from both physician and patient perspectives and the impact of devices on engagement and monitoring.

Methods
Participants with a history of moderate to severe persistent asthma, seen by a pulmonologist at a hospital, were included in this study. The inclusion criteria involved being aged ≥18 years and having access to an Android or iOS mobile device with internet. We provided patient questionnaires to assess the app’s usefulness and evaluate its features. We monitored remote spirometry and oximetry data, app check-ins, alerts, and escalations during this study’s time window. Data were reviewed daily and predetermined criteria were set to escalate for physician review based on the patient’s symptoms and objective data.

Results
Overall, 25 patients were included in this pilot. The mean age was 57 (SD 10.7) years and a majority (n=23, 92%) were female. A baseline questionnaire, which was used to rate the app, indicated that the ease of check-in and ease of modification to the patient’s asthma plan were the 2 highest rated features. In total, 2066 check-ins (1550 green, 506 yellow, and 10 red check-ins) and 1155 spirometry sessions were recorded during this 3-month period. Further, 64% (14/22) and 91% (20/22) of patients were found to have peak flows in their red and yellow zones at least once, respectively. During the course of this study, 484 alerts were recorded and evaluated by the team, of which 37.2% (n=180) required an escalation to the physician; this included a transfer to a medical facility, change in respiratory medication, or further education.

Conclusions
In this pilot study, we demonstrated the feasibility of implementing a novel RPM platform in patients with asthma. Our platform showed high patient engagement and satisfaction and provided physicians with real-time subjective data to evaluate patients remotely that aids in clinical decision-making. The escalations prevented patients from having an exacerbation or flare up, which led to the prevention of an emergency department visit. Continuous monitoring of chronic disease has benefits over episodic monitoring. It allows for improved quality of life, better outcomes, and huge health care savings.
Three-dimensional morphologic analysis of the maxillary alveolar bone after anterior tooth retraction with temporary anchorage devices
Authors: Ito Arata , Mayama Atsushi , Oyanagi Toshihito , Ogura Hiroki , Seiryu Masahiro , Fukunaga Tomohiro , Kitaura Hideki , Mizoguchi Itaru 
Published: November 2023

ABSTRACT

Objectives
To investigate three-dimensional (3D) morphologic changes in the alveolar bone around the maxillary central incisors of patients who underwent premolar extraction and subsequent anterior tooth retraction using temporary anchorage devices (TADs).

Materials and Methods
The subjects consisted of 16 patients with bimaxillary protrusion. The maxillary anterior teeth were retracted using sliding or loop mechanics and TADs for anchorage reinforcement. Cephalograms and computed tomography scans taken pretreatment and posttreatment were registered with respect to the palatal structures. The movement of the maxillary central incisors and morphologic changes in the anterior alveolar bone were evaluated quantitatively.

Results
Displacement in the palatal direction was observed in the alveolar bone around the incisors and the interdental septum. The displacement and bone remodeling/tooth movement ratio were larger on the labial side than the palatal side, and decreased progressively from the crest to apex level. The bone thickness was significantly increased on the labial side and decreased on the palatal side.

Conclusions
Regional differences exist in morphologic changes of the alveolar bone during anterior tooth retraction using TADs. Attention should be paid to the crest region of the palatal alveolar bone because of its small original thickness and low remodeling activity.
Edge Behavior of the k-ε Model in Boundary Layers: Analysis and Improvement
Authors: Abe Hiroyuki , Nambu Taisuke , Mizobuchi Yasuhiro , Spalart Philippe R. 
Published: November 2023

We examine the outer-edge behavior in a turbulent boundary layer (TBL) predicted by the [Formula: see text] model with reference to a mathematical analysis of Cazalbou–Spalart–Bradshaw (CSB) (Physics of Fluids, Vol. 6, No. 5, 1994, pp. 1797–1804). Particular attention is given to one-dimensional analyses at the edge of the turbulent region. An inverted parabola analysis demonstrates that the correct edge behaviors of [Formula: see text], [Formula: see text] and [Formula: see text] are reproduced for both high- and [Formula: see text] models. For a ramp analysis following CSB (involving the velocity field), a set of diffusion coefficients for [Formula: see text] [Formula: see text] that violates the CSB constraint, however, yields an unrealistic velocity profile at the interface between the turbulent and nonturbulent regions due to the excessively small turbulent diffusion. We therefore propose improved diffusion coefficients by considering both the CSB constraint and requirements in wall turbulence, and calculate a range of two-dimensional aeronautical flows with [Formula: see text] to clarify if the one-dimensional analyses support the predictions in realistic flows, fully coupled with the velocity field. Indeed, the corrected diffusion coefficients provide reasonable predictions for both the channel and TBL but also TBLs involving turbulent separation when [Formula: see text] becomes large. Over an airfoil, the correction improves the prediction for [Formula: see text] by a few counts.
It’s a Fine Line between Sadism and Horror
Authors: Woodcock Scott 
Published: November 2023

Much has been written about the puzzling aesthetic appeal of horror films that include scenes of brutal, graphic violence. More recently, however, some philosophers have proposed that viewing certain horror films as a source of entertainment is morally problematic because of the impact they might have on our moral psychology. By contrast, Ian Stoner argues that viewing fictional depictions of violence in horror films is not morally problematic because horror films do not present violence in ways that risk damaging the kinds of reactive attitudes required to exhibit a well-functioning moral psychology. In this paper I note some the ways in which Stoner is correct about horror films, yet I argue that he has overstated his case for the permissibility of viewing all instances of horrific violence as entertainment.
Primary and secondary constipation: causes of occurrence, methods of correction
Authors: Kharchenko N. V. , Shendryk V. H. , Korulia I. A. , Kharchenko V. V. , Lopukh I. Y. 
Published: November 2023

Constipation develops in up to 30% of the adult population of economically developed countries. The main reason for the occurrence of constipation are lifestyle features: inactivity and unbalanced nutrition. During constipation, motor, absorptive and secretory functions of the large intestine change. Treatment of patients with constipation begins after determining the cause of constipation and excluding lesions of the large intestine that could provoke constipation. Both soluble and insoluble dietary fibers should be increased in the diet. The main approach to treatment is the use of combined therapy, and if the effect is insufficient, laxatives administration is recommended.
Objective — to evaluate the effectiveness and safety of using the multicomponent laxative EasyDo in the treatment of patients with functional constipation and irritable bowel syndrome (IBS) with constipation.
Materials and methods. The study involved 28 patients with functional constipation/IBS with constipation, who met the Rome IV criteria (2016). Women prevailed in this group, 19 (68.0%). IBS with constipation was diagnosed in 15 (53.6%) cases, and functional constipation in 13 (46.4%) subjects. Patients were administered EasyDo (Prakruti Products Pvt Ltd, India), which includes a mixture of natural extracts of medicinal plants, namely: Operculina turpethum, Cassia fistula, Terminalia chebula, Glycyrrhiza glabra 2 tablets in the evening. Besides, recommendations were given to change the lifestyle, to add dietary fibers into the diet with individual selection of the dose. The dynamics of the following symptoms were evaluated: lack of regular bowel movement, difficulty in defecation, feeling of incomplete emptying, flatulence, etc. The intensity of each of these symptoms was assessed with the use of a 5‑point Likert scale.
Results. The analysis of EasyDo effectiveness was carried out after three weeks of the drug administration. All patients noted positive changes, but the degree of positive dynamics was different. After the treatment, the number of bowel movements per week increased. Three or more stools without unproductive straining were recorded in 21 (75%) patients. The severity of complaints in most patients has significantly decreased.
Conclusions. The obtained results demonstrated the following EasyDo effectiveness: considerable in 21 (75%) patients, moderate in 6 (21.4%) patients, no effects in one (3.6%) patient. The combination of plant components in EasyDo has a mild laxative effect, it is well tolerated and can be recommended in the complex treatment of patients with constipation.
COMPARATIVE ANALYSIS OF LONG-TERM OUTCOMES FOLLOWING THE STIMULATION OF CARDIAC CONDUCTION SYSTEM AND RIGHT VENTRICULAR PACING IN PATIENTS WITH BRADYARRHYTHMIAS
Authors: Perepeka Ye. O. 
Published: November 2023

Introduction. Right ventricular myocardial pacing induces asynchronous ventricular contraction, potentially resulting in pacing-induced cardiomyopathy and adverse long-term clinical outcomes. Conduction system pacing is a physiological alternative to right ventricular myocardial pacing. The objective of this study is to analyze the long-term outcomes of the conduction system pacing in comparison with right ventricular myocardial pacing in patients requiring permanent ventricular pacing and who have preserved initial left ventricular ejection fraction (≥ 50%). Materials and methods. 48 patients with indications for permanent ventricular pacing were selected for comparative analysis. Of these, 18 patients had cardiac conduction system pacing and 30 patients had right ventricular myocardial pacing. Permanent pacemaker implantation in both groups of this study was performed from 2012 to 2022. Patients in both groups had to meet the following selection criteria for this study: 1) preserved systolic function of the left ventricle at the time of pacemaker implantation (≥ 50%); 2) total percentage of ventricular pacing from the time of implantation had to be not less than 90%.
Results. The observation period was 35.3 ± 37 months in the conduction system pacing group and 46 ± 28.73 months in the right ventricular pacing group. Since the time of pacemaker implantation, pacing-induced cardiomyopathy occurred in 7 (23%) patients in the right ventricular pacing group and in none in the conduction system pacing group. The mean left ventricular ejection fraction at the control visit was significantly lower in the right ventricular pacing group (51.59 ± 8.55 vs. 58.64 ± 4.58%, p =.004). A significant reduction in global longitudinal strain was observed in the right ventricular pacing group compared to the conduction system pacing group (14.22 ± 3.66 vs. 18.49 ± 2.5%, p = <.001). Paced QRS width was significantly greater in the right ventricular pacing group (152.32 ± 18.13 vs. 119.12 ± 8.8 ms, p <.001). Conclusions. Applying new physiological methods of cardiac pacing enables to avoid the negative consequences of an asynchronous pattern of ventricular activation during conventional right ventricular pacing.
Penerapan Model Inkuiri Terbimbing untuk Meningkatkan Kemampuan Berpikir Kritis dan Sikap Ilmiah Siswa dalam Pembelajaran IPA Siswa Kelas V SDN 9 Bengkulu Tengah
Authors: Julimah Julimah Julimah , Winarni Endang Widi , Hmbali Daimun Hambali 
Published: November 2023

Penelitian ini bertujuan untuk meningkatkan aktivitas, kemampuan berpikir kritis, dan sikap ilmiah siswa pembelajaran IPA melalui model inkuiri terbimbing di kelas V SDN 9 Bengkulu Tengah. Penelitian yang dilakukan adalah penelitian tindakan kelas (Classroom action research) sebanyak 3 siklus. Instrumen yang digunakan yaitu lembar observasi aktivitas pembelajaran, tes kemampuan berpikir kritis, dan lembar observasi sikap ilmiah. Hasil yang dicapai dalam penelitian ini yaitu: (1) aktivitas pembelajaran siklus I sebesar 63,64% dengan kategori Cukup, siklus II sebesar77,27% dengan kategori Baik, dan siklus III sebesar 90,91% dengan kriteria Sangat Baik; (2) kemampuan berpikir kritis untuk indikator memfokuskan pertanyaan siklus I sebesar 76,25%, siklus II sebesar 86,25%, dan siklus III sebesar 95%, indikator menjelaskan secara sederhana siklus I sebesar 58,33%, siklus II sebesar 72,50%, dan siklus III sebesar 76,67%, indikator membangun keterampilan dasar siklus I sebesar 60%, siklus II sebesar 81,67%, dan siklus III sebesar 88,33%, indikator menyimpulkan siklus I sebesar 91,25%, siklus II sebesar 97,50%, dan siklus III sebesar 100%; (3) sikap ilmiah siklus I untuk indikator rasa ingin tahu yang tinggi sebesar 76,20%, siklus II sebesar 79,30%, dan siklus III sebesar 82,95% siklus I untuk indikator ulet dan tidak putus asa siklus I sebesar 76,45%, siklus II sebesar 79,40%, dan siklus III sebesar 83,80%, indikator kreatif siklus I sebesar 72,85%, siklus II sebesar 77,05%, dan pada siklus III sebesar 82,95%. Berdasarkan hasil penelitian dapat disimpulkan bahwa penerapan model inkuiri terbimbing dapat meningkatkan kemampuan berpikir kritis dan sikap ilmiah siswa Kelas V SDN 9 Bengkulu Tengah.
Effectiveness of Bacillus pseudomycoides strain for Biocontrol of Early Blight on tomato plants
Authors: ElSharawy Ahmed A. , Eid Nerhan A. , Ebrahiem Azza M.Y. 
Published: November 2023

Alternaria early blight is an air-borne and soil-borne pathogen that cause losses and damages that can reach up to 80% in tomato production. In our work, the immediate antagonistic effect of Bacillus pseudomycoides was inspected against Alternaria early blight of tomato. Bacillus pseudomycoides (Bp1) (OQ629426) gave inhibition efficacy against A. solani growth, being, 74.22 %. Invitro, Bp1 had the capability to produce the endogenous plant auxin (IAA) it was 18.9 (µg/100 mL), the quantity of GA 9.4 (µg/100 mL), 95.8 μ Deferroxamine mesylate. Tomato plants treated with B. pseudomycoides registered the least disease severity, being 50 and 40 % in Mancozeb + ALS and Bp1+ ALS treatments with high efficiency to control the severity between 75 and 100 % respectively. Tomato plants treated with B. pseudomycoides showed improved growth characteristics as compared with the untreated control. Plants with bacterial treatment conferred 45.6 cm shoot length, 2.9 (g∕plant) fresh weight and 0.7 (g∕plant) Dry weight. The highest increase in the activity of polyphenol oxidase (PPO) and peroxidase (POD) was observed in the infected leaves of tomato plants treated with B. pseudomycoides Bp1 (T4) (4.6, 6.9 m/g f. w.) respectively, followed by treatment of plants with Mancozeb (T3) (3.9, 5.4 m/g f. w.) respectively, compared to other treatments. This study suggested that B. pseudomycoides is a promising biocontrol agent against Alternaria early blight. This bacterium may represent an important source of potential antimicrobial bio-agent against Alternaria early blight disease, also it may play a role in the development of integrated control programs in future studies.
Relationship between wool cortisol, wool quality indices of Australian Merino rams and climatic variables in Tasmania
Authors: Cobb Troy , Hantzopoulou Georgia-Constantina , Narayan Edward 
Published: November 2023

IntroductionAustralia is the world’s largest producer and exporter of fine wool. External factors (i.e., non-genetic) that affect wool phenotype need to be identified and managed to minimize any negative effects on wool quality. Climatic stress is one external event that can affect wool phenotype, other stressors include shearing, nutrition, disease, pregnancy, and lambing. This study focuses on the relationship between Saxon Merino ram wool phenotype and wool cortisol. The hypotheses had two parts (i) wool cortisol levels would vary seasonally and variations would correlate with wool phenotype (ii) that these seasonal variations would also correlate with thermal indices.MethodsCortisol levels in Saxon Merino ram wool samples were determined using a cortisol enzyme-immunoassay (EIA) using polyclonal cortisol antibody. The wool cortisol results were correlated for significance with thermal indices including Temperature Humidity Index [THI] and Chill Index [CI] obtained from the Australian Bureau of Meteorology.ResultsPart 1 of hypothesis one was supported with wool cortisol showing significant seasonal variation. Part 2 of hypothesis 1 was not supported, with no statistically significant causality present between total wool cortisol levels and the price index of Saxon Merino ram wool. However, there was significant causality between wool cortisol and coarse edge measurement (CEM) of wool. Hypothesis 2, the proposal that thermal indices would impact on wool cortisol was also not supported.DiscussionIt can be concluded that although conclusive causality between total wool cortisol and wool phenotype quality could not be ascertained, there were indirect effects of cortisol levels on wool phenotypes with significant effects on the CEM. The CEM of Merino Saxon ram wool can be manipulated by assessing and managing cortisol levels during the growth cycles of Merino wool, through appropriate nutrition and husbandry procedures stress could be managed.