bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemical Composition of Essential Oils of Medicinal Plants Grown in the Thrace Region in Türkiye, Hypericum perforatum L.
Authors: Güler Fevziye Deniz , Ozdemir Nurullah 
Published: October 2023

Background There are many active substances in the composition of the Hypericum perforatum L. plant that have different and complex structures and show different pharmacological effects. It was accepted as a medicinal plant by the World Health Organization in 2002, and it is given a detailed place in the monographs under the name Hyperici herba. In these monographs, the anti-bacterial, anti-viral, anti-depressant, protein kinase-C inhibitor, and wound-healing effects of the plant were described. Objectives The aim of this study is to determine the essential oil components in the samples of the H. perforatum L. plant, which is widely grown in the Thrace region in Türkiye. Materials and Methods H. perforatum L. plant growing naturally in the provinces of the Thrace region was collected, and the essential oils of the plant were obtained by using the hydro distillation method after the collected herbs were dried. Chemical content analyses were performed on a gas chromatography-flame ionization detection (GC-FID). Results The main components of the essential oil of the plant are sesquiterpenes (ß-caryophyllene, caryophyllene oxide, β-selinene, α-selinene, β-farnesene, α-amorphene, spathulenol), alcohols (1-tetradecanol, 1-tridecanol, phytol, and alpha cadinol), and fatty acids (pentadecanoic acid, palmitic acid, and 9, 12 octadecadienoic acid). Conclusion This is the first study to determine the chemical composition of essential oil in H. perforatum L. samples collected from the Thrace region in Türkiye. The essential oil content of the plant can be affected by factors such as the developmental stages of the plant (preblooming, flowering stage, and fruiting time), use of fresh or dry plant material, extraction method, genetic parameters, and climate.
Preoperative degree of deformity and underlying disease affect the postoperative deformity of joint-preserving hallux valgus surgery
Authors: Takami Kenji , Tsuji Shigeyoshi , Owaki Hajime 
Published: October 2023

Background The combination of distal osteotomy with lateral dissection in joint-preserving surgery for severe hallux valgus deformity has recently begun to yield encouraging results. We examined the frequency of complications and risk factors of those for joint-preserving surgery in patients with and without rheumatoid arthritis (RA). Methods A retrospective, observational study of 72 feet (27 patients with RA) was performed. The inclusion criteria were patients who underwent joint-preserving surgery for hallux valgus deformity at our hospital between January 2008 and March 2016 who could be followed up with for longer than 12 months. Results The mean preoperative and immediate postoperative hallux valgus angles (HVA) were 41.8 and 4.4, respectively. The mean preoperative and immediate postoperative intermetatarsal angles between the first and second metatarsal bones (M1-M2A) were 14.6 and 5.8, respectively. At the final postoperative evaluation, the mean HVA was 8.8 and the mean M1-M2A was 6.4. Data were compared among the patients with complications (recurrent valgus deformity, varus deformity), and those without complications (normal HVA) at the final postoperative evaluation. The rate of RA in the varus deformity group was 71.4%, which tended to be higher than in other groups ( p = .058). The mean preoperative HVA were 48.2 and 52.6 in the group of recurrent valgus deformity and varus deformity, which was higher than the normal HVA group ( p = .001). Conclusions High preoperative HVA was a risk factor for the recurrence of valgus deformity. Most of the varus deformities were observed in the RA group with high preoperative HVA; therefore, caution should be exercised in operating on patients with severe deformity or those with RA. Level of evidence III.
Efficacy and safety of bone management agents administered at 12 weeks vs. 4 weeks in patients with bone metastases: A systematic review
Authors: Sato Junya , Kodaira Makoto , Harada Hiroyuki , Iguchi Haruo , Yoshida Taichi , Shibata Hiroyuki ,   Diagnosis and treatment of bone metastasis: comprehensive guideline (the 2nd Edition) developing group
Published: October 2023

Background Bone modifying agents (BMAs) have been used to prevent skeletal-related events (SRE) in cancer patients with bone metastases. In this meta-analysis, efficacy and adverse events (AEs) were studied based on a de-escalation strategy in which the BMA dosing interval was prolonged from 4 to 12 weeks. Methods PubMed, Cochrane, ICHUSHI, and CINAHL were searched for articles on BMA dosing intervals from outcomes measured were the incidence of SRE and related various AEs. A quantitative meta-analysis was performed using a random-effects model to calculate relative risk ratios (RRs) and 95% confidence intervals (CIs). Result The meta-analysis included three randomized controlled studies (RCTs) of Zoledronic acid hydrate (ZA) ( n = 2663) and six RCTs ( n = 141) on BMA other than ZA. There was no difference in the incidence of SREs when comparing the dosing frequency of 12 versus 4 weeks for BMA (RR = 1.21, 95% CI [0.82–1.78], p = 0.33). Further, AEs related to treatment discontinuation were significantly less frequent with ZA given every 12 weeks than when given every 4 weeks (RR = 0.51 [0.30–0.89], p = 0.02). In particular, renal dysfunction leading to grade ≥3 or discontinuation of treatment with ZA occurred significantly less frequently with every 12-week dosing (RR = 0.33 [0.12–0.91], p = 0.33). Conclusion This meta-analysis showed no influence of BMA de-escalation on the incidence of SRE; nevertheless, AEs appeared to reduce with the de-escalated usage of ZA.
Mental Health, Environmental, and Socioeconomic Geographic Factors of Severe Drug Addiction: Analysis of Rehabilitation Center Data in Indonesia
Authors: Dewabhrata Wijaya , Ahsan Abdilah , Bella Adrianna , Amalia Nadira , Kusuma Dian , Pertiwi Yuyu Buono Ayuning 
Published: October 2023

Background: A growing number of recent literatures have attempted to document the factors related to drug use in different contexts, but limited studies analyzed the factors related to patient’s severity level. Objective: We aimed to examine the correlates of behavioral, environmental, socioeconomic, geographic factors, and severe drug addiction. Methods: We used a sample of 6790 people who use drugs (PWUD) from rehabilitation centers during 2019 to 2020 in Indonesia. Data were obtained from Drugs Rehabilitation Information System (SIRENA) by the Indonesian National Narcotics Agency (BNN) during 2019 to 2020. SIRENA used the adapted version of WHO’s Addiction Severity Index (ASI), which assesses patient’s addiction severity level and relevant factors. A composite of the ASI factors is classified as “poor” or “serious” if its score is 4 or higher. The data was analyzed using logistic regression model to estimate correlations of severe drug addiction. Results: We found a high prevalence (65.08%) of our sample reported having severe drug addiction, which needed intervention and support. Poor psychiatric condition (OR = 4.02, CI: 2.97-5.44), serious work-related issue (OR = 2.10, 1.75-2.51), poor medical condition (OR = 2.01, 1.32-3.06), and serious family and social problems (OR = 2.56, 2.15-3.05) were significantly associated with severe drug addiction. Male users had higher odds of severe drug addiction (OR = 1.81, 1.55-2.20), compared to female counterparts. Patients in urban areas had higher odds of severe drug addiction (OR = 1.19, 1.1-1.3) than those in rural. Those in less developed regions (eg, Sumatera, Kalimantan, and Sulawesi) had higher odds of severe drug addiction (OR = 2.33, 1.9-2.9), compared to those in the most developed region (eg, Java and Bali). Conclusion: This evidence can help policymakers in refining the harm reduction policies in Indonesia and other countries with similar settings.
Future thinking and anticipatory pleasure in adolescents with major depression: Association with depression symptoms and executive functions
Authors: Lakshmi Pooja M , Kishore M Thomas , Roopesh Bangalore N , Jacob Preeti , Rusanov Danielle , Hallford David J 
Published: October 2023

Objective Impairments in episodic future thinking and anticipatory pleasure were noted to explain the depressive symptoms in adults however similar studies are not there in adolescents. This study examined whether there are impairments in episodic future thinking and anticipatory pleasure in clinically-depressed adolescents as compared to non-depressed adolescents, and their association with depression when controlled for executive functions and anxiety symptoms among the depressed adolescents. Methods The study included 29 adolescents with major depression and 29 adolescents from local schools through convenient sampling technique. All the participants were assessed with standardized measures of depression and anxiety, episodic future thinking, anticipatory pleasure and executive functioning. Results Depressed adolescents significantly differed from the non-depressed adolescents in autobiographical memory specificity, anticipatory pleasure, and specific dimensions of executive functions. The ANCOVAs indicated executive function slightly attenuated group differences on future specificity which were still non-significant (all p’s > .05). For memory specificity and for anticipatory pleasure, group differences were still significant at p < .05 level. Conclusion Adolescents with major depressive episode may display similar, but less pronounced, impairments in future thinking than what is previously reported in adults. Though, autobiographical specificity is prominent. The deficits are attributable to depression than executive functioning deficits.
Increased door-to-puncture time during off-duty hours results in poor treatment outcomes for acute ischemic stroke: A subanalysis of the K-NET registry
Authors: Ishikawa Shun , Miyake Shigeta , Akimoto Taisuke , Nakai Yasunobu , Amano Yu , Yamamoto Ryoo , Amari Kazumitsu , Yamamoto Tetsuya , Takeuchi Masataka , Morimoto Masafumi , Tsuboi Yoshifumi , Kaku Shogo , Ayabe Junichi , Akiyama Takekazu , Yamamoto Daisuke , Ito Hidemichi , Onodera Hidetaka , Hagiwara Yuta , Takaishi Satoshi , Hasegawa Yasuhiro , Ueda Toshihiro ,   K-NET Registry Investigators
Published: October 2023

Background For patients who undergo endovascular treatment for acute ischemic stroke, the total time for treatment may increase during off-duty hours leading to worse outcomes. The present study compared endovascular treatment outcomes for on-duty and off-duty hours and examined factors that could be responsible for the prolonged treatment of patients in a multicenter registry. Methods The study group comprised 1571 patients listed in the multicenter stroke registry (K-NET) who had undergone endovascular treatment between January 2018 and June 2020. The modified Rankin Scale (mRS), evaluated at 90 days after stroke onset, was utilized as the primary outcome. Patients were divided into on-duty and off-duty patients based on admission time. Multivariate logistic regression analysis was used to identify the independent factors that increased the time from admission to puncture during the off-duty period. Results The mean mRS score at 90 days after stroke onset was 2.9, similar in both on-duty and off-duty patients, with no significant difference ( p = 0.77); however, significant differences were observed in time from door-to-puncture (74.7 vs. 88.8, p < 0.01). Additionally, the mRS score at 90 days worsened significantly for door-to-puncture time >60 min in the off-duty period. Multivariate logistic regression analysis revealed that a low National Institute of Health Stroke Scale (NIHSS) score, high pre-mRS score, posterior circulation, and diabetes were independent indicators of door-to-puncture time >60 min during the off-duty period. Conclusion Door-to-puncture time >60 min during off-duty hours was associated with poor outcomes related to low NIHSS, high pre-mRS, posterior circulation, and diabetes.
Comprehensive preparation strategies for a world-class endurance athlete competing in major international competitions in hot environmental conditions: A case study
Authors: Carr Amelia J , Sharma Avish P , Ross Megan LR , Vallance Brent S 
Published: October 2023

Purpose To document a world-class race walking athlete's preparation for the 2019 International Association of Athletics Federations (IAAF) World Championships (Doha, Qatar), including periodized training, physiological data, cooling strategies and nutritional practices. Methods Physiological data (VO2max, mL·kg−1·min−1; submaximal economy, mL·kg−1·min−1; and %VO2max), training volume (km) and intensity (min·km−1) were recorded (January–May 2019). Additional training strategies and interventions (altitude training, heat acclimation/acclimatization, cooling methods and pre- and during-race nutrition) were described (February–October 2019). Performances in IAAF-sanctioned 20 km races were also reported. Results The athlete's highest VO2max result was 74.6 mL·kg−1·min−1, and his highest 4 mmol·L−1 walking speed was 15.7 km·h−1. The best submaximal economy measures (the lowest proportional oxygen use at 13 km·h−1) were 48.4 mL·kg−1·min−1 (65.2% VO2max). The best performance outcome was a bronze medal-winning performance at the 2019 IAAF World Championships (32°C; 77% RH). Six blocks of altitude training were performed (119 days). Five blocks of heat acclimatization training (127 days), one block of heat acclimation training (8 days) and two blocks of post-training passive heat sessions (16 days) were completed. Internal and external cooling strategies were used, and the athlete's nutritional intake focused on carbohydrate and fluid intake prior to and during races, pre-race supplementation with sodium bicarbonate using chronic and acute protocols, caffeine supplementation during races and pre-race hyperhydration. Conclusion The strategies used by this elite athlete included repeated heat acclimation, heat acclimatization, passive heat exposure, hypoxic training and heat mitigation strategies. Similar strategies may provide benefit to elite athletes preparing for major international competitions in hot conditions.
The predictability of ASDAS on drug survival in patients with ankylosing spondylitis on biologic therapy: data from the KOBIO registry
Authors: Kim Jinhyun , Kim Min Jung , Oh Geun Young , Lee Sun Kyung , Kim Taeeun , Shin Kichul 
Published: October 2023

Background: The Ankylosing Spondylitis (AS) Disease Activity Score (ASDAS) is largely used for assessing disease activity in patients with AS. Objectives: We aimed to investigate the predictability of ASDAS on drug survival in patients with low Bath AS Disease Activity Index (BASDAI) during biologic therapy. Design: Using data from multi-center, prospective, observational prospective cohort, Korean College of Rheumatology Biologics and Targeted Therapy (KOBIO) registry. Methods: The study population consisted of patients enrolled in the KOBIO registry from December 2012 to December 2018. The baseline demographic data and variables such as extra-articular manifestations, HLA-B27 positivity, family history of spondyloarthritis, ASDAS C-reactive protein (CRP), BASDAI, and Bath AS Functional Index scores were collected from the database. The disease activity indices were followed yearly after initiating a tumor necrosis factor (TNF) inhibitor (TNFi). Disease activities were defined as high (ASDAS-CRP ⩾ 2.1, BASDAI ⩾ 4) and low (ASDAS-CRP < 2.1, BASDAI < 4). Results: Data from 1773 patients were analyzed. Among 269 patients with low BASDAI at baseline, 151 (56.1%) patients had high ASDAS-CRP, yet in 142 patients with low ASDAS-CRP at baseline, only 24 (16.9%) patients had a high BASDAI. High ASDAS-CRP captured more patients who had initiated or switched to a TNFi than those with high BASDAI (92.5% versus 84.8%, respectively, p < 0.001). Moreover, among AS patients with low BASDAI after 1 year of therapy, drug persistence in the following year was significantly lower in patients with high ASDAS than in those with low ASDAS (68.7% versus 82.5%, p < 0.001). Conclusion: ASDAS-CRP not only has its advantages over BASDAI in assessing disease activity but also low ASDAS-CRP at 1 year can be a marker of long-term drug survival of TNFi therapy.
Association between fluoride exposure and blood pressure
Authors: Hung Man , Mohajeri Amir , Vu Teresa , Moparthi Hyma , Lipsky Martin S 
Published: October 2023

Objectives: This study investigated whether fluoride was associated with an increased prevalence of high blood pressure (BP) among adolescents in the United States. Methods: The study sample consisted of 2015–2016 National Health and Nutrition Examination Survey participants aged 13–17 years. Independent-samples t-tests, Chi-square tests, and regression models were used to analyze the data. Results: A total of 814 participants met the study criteria. The findings showed that the proportion of patients with high levels of water or plasma fluoride in the high BP group was higher than that in the normal BP group. However, after adjusting for sociodemographic covariates, neither water nor plasma fluoride levels were significantly associated with a high BP. Conclusions: This study did not find an association between either water or plasma fluoride levels and high BP. Further study is needed to exclude a dose dependent effect at higher levels of fluoride.
Survey Highlighting Impostor Phenomenon (SHIP): Evaluating the Prevalence of Impostor Phenomenon Among Physicians in a Military Treatment Facility
Authors: Penick Emily , Beltran Thomas , Foglia Lisa 
Published: October 2023

OBJECTIVES Impostor Phenomenon (IP) describes feelings of distrust in one's own capabilities or accomplishments. This experience exists across many professional settings, affecting men and women across diverse backgrounds. IP has not been studied within a military health system. The purpose of this study was to evaluate the prevalence of IP among physicians at a military hospital. METHODS An online survey was constructed incorporating the Clance Impostor Phenomenon Scale (CIPS) and demographic data. All physicians at the institution received the survey link via email and the survey remained open for 1 month for completion. Multivariable analysis was performed to identify significant differences among groups as well as characteristics associated with IP. Exploratory factor analysis was used to examine the factor structure of the CIPS. RESULTS The response rate was 25% (94/376). Forty-one respondents (44.1%) had CIPS scores ranging between 41 and 60, classifying the respondent as having moderate IP experiences. Differences in scores were noted for age and years of experience (both P < .01). No differences were noted based on gender, self-reported race/ethnicity, or surgical versus nonsurgical specialty. Active-duty respondents had a mean IP score of 62 (SD  =  16) and civilian respondents had a mean IP score of 49 (SD  =  12, P < .01). CONCLUSION With nearly half (46.3%) of respondents reporting frequent or intense IP experiences, this study underscores the pervasiveness of the issue and indicates concordance with previously published data. IP is not limited to certain subgroups or gender identity but rather is a common issue which may negatively affect a physician's well-being.
EKG Acquisition Curriculum for Pediatric Trainees
Authors: Obsekov Vladislav , Teng Christopher , Balmer Dorene F 
Published: October 2023

OBJECTIVES Pediatric residency trainees interface with electrocardiograms (EKG) as part of routine clinical care. Depending on workflow and availability of support staff, trainees may be required to obtain EKGs on patients, though training on this skill varies. Our intervention seeks to train incoming pediatric residents on obtaining EKGs from pediatric patients and identifying common problems that may result in acquisition of low-fidelity EKGs. METHODS A team of physicians, EKG technicians, and simulation educators designed a 30-min didactic and experiential learning opportunity for incoming pediatric trainees held prior to their start of clinical responsibilities. During the session, trainees were introduced to the basics of EKG acquisition and common quality issues that arise. Afterwards, they practiced placing EKG leads on a mannequin and a live model. A pre- and post-session survey was utilized to assess the session's utility and participant's learning. RESULTS The intervention was perceived as a valuable experience by participants over the course of 2 years. We found increased participant comfort with performing and troubleshooting EKGs ( P<.001). There was a 33% improvement in quality assessment of EKG rhythm strips after the session ( P<.001). CONCLUSION Given the importance of EKGs to the care of pediatric patients, it is essential that pediatricians receive adequate training in acquiring and assessing EKG quality. This intervention was deemed to be highly useful with a demonstrated improvement in EKG troubleshooting skills among first year pediatric residents. This session improves learner comfort with essential clinical responsibilities and identification of low-quality EKGs that often warrant repeat testing.
Exploring Anki Usage Among First-Year Medical Students During an Anatomy & Physiology Course: A Pilot Study
Authors: Levy Joshua , Ely Kencie , Lagasca Gemma , Kausar Hiba , Patel Deepal , Andersen Shaun , Georges Carlos , Simanton Edward 
Published: October 2023

Objectives As medical schools worldwide condense the preclinical phase of medical education, it is increasingly important to identify resources that help medical students retain and employ the medical information. One popular tool among medical students is an application called Anki, a free and open-source flashcard program utilizing spaced repetition for quick and durable memorization. The purpose of this study is to determine how variable Anki usage among first-year medical students throughout a standardized anatomy and physiology course correlates with performance. Methods We designed a novel Anki add-on called “Anki Stat Scraper” to collect data on first-year medical students at Kirk Kerkorian School of Medicine during their 8-week anatomy and physiology course. Anki users (N = 45) were separated into four groups: Heavy (N = 5), intermediate (N = 5), light (N = 16), and limited-Anki (N = 19) users, based on the time each student spent on the flashcard app, how many flashcards they studied per day, and how many days they used the app prior to their anatomy and physiology exam. A 14-question Likert scale questionnaire was administered to each participant to gauge their understanding of Anki and how they used the app to study. Results Heavy and intermediate Anki users had higher average exam scores than their counterparts who did not use Anki as a study method. Average exam scores were 90.34%, 91.74%, 85.86%, and 87.75% for heavy, intermediate, light, and limited-Anki users respectively (p > 0.05). Our survey demonstrated that Anki users spent an average of 73.86% of their study time using Anki, compared to an average of 36.53% for limited-Anki users (p < 0.001). Conclusion Anki users did not score significantly higher compared to limited-Anki users. However, survey responses from students believe that Anki may still be a useful educational tool for future medical students.