bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sitagliptin with Piperine Pharmacodynamic and Pharmacokinetic Studies in Normal and Diabetic Rabbits
Authors: Pamu Sagar , Patyar Sazal , Thakkalapally Lakshmi 
Published: August 2023

Background:
Food-drug interactions caused by dietary alkaloids like piperine may significantly
impact medication metabolism and excretion. In this study, we studied piperine's effect on
sitagliptin's PD and PK.

Methods:
The research assessed the food-drug interaction in normal and diabetic rabbits to demonstrate
how piperine affects the PD and PK of sitagliptin. Piperine, sitagliptin, and sitagliptin plus piperine
treatment were administered to normal and diabetic rabbits. Blood samples were taken from the
treated rabbits at predetermined intervals on days 1, 3, 7, and 21. Plasma was extracted from the obtained
blood samples, and glucose levels were measured by the GOD-POD technique and insulin levels
by ELISA. The extracted plasma samples collected on days 1 & 21 at predetermined intervals were
exposed to HPLC analysis for estimation of PK parameters of sitagliptin. In both normal and diabetic
rabbits, statistically comparisons were done between PK/PD of sitagliptin alone and in combination
with piperine.

Results:
Piperine plus sitagliptin has no significant difference in glucose levels, percent blood glucose
reductions, and insulin levels on 0, 1, 3, 7, 14 & 21st days in normal rabbits as compared with
sitagliptin alone, and this may be because sitagliptin has no hypoglycemic effect. In diabetic rabbits,
sitagliptin plus piperine significantly reduced blood glucose levels, raised the percent blood glucose
reductions, and increased insulin levels on days 1, 3, 7, 14, and 21, compared with sitagliptin alone,
demonstrating antihyperglycemic efficacy. Antihyperglycemic efficacy results indicate that sitagliptin
with piperine has an additive effect on releasing more insulin, which is considered a PD interaction. In
the PK study, sitagliptin plus piperine significantly raised the AUC0-∞, AUC0-t, AUMC0-∞, and
AUMC0-t and lowered the CL of sitagliptin compared to sitagliptin alone on days 1 and 21 in normal
and diabetic rabbits. Furthermore, the Tmax of sitagliptin did not change significantly, and the Ke, t1/2,
and MRT varied non-significantly when piperine was administered concurrently. Additionally, Vd
was also non-significantly altered in normal rabbits. This study's results suggest that piperine inhibits
the CYP3A4 metabolic enzyme and P-gp (P-glycoprotein) substrate of sitagliptin in normal and diabetic
rabbits, indicating a food-drug interaction.

Conclusion:
In normal rabbits, this study found no PD interaction. A PD interaction between piperine
and sitagliptin showed the additive effect in diabetic rabbits by showing an antihyperglycemic activity.
As per study findings, in normal and diabetic rabbits, piperine significantly increased the bioavailability
of sitagliptin. However, the anticipated clinical response in humans cannot always be predicted
from animal studies, so further research is required to evaluate drug interaction in humans.
Quality of Life of Mothers and Fathers of Children with Autism Spectrum Disorder in Jordan
Authors: Ahmed Eiman A. , Alkhaldi Sireen M. , Alduraidi Hamza , Albsoul Rania A. , Alhamdan Mohammad Z. 
Published: August 2023

Background:
Parenting children with autism spectrum disorder (ASD) is widely identified to be associated with life-long impairment in parents’ quality of life (QoL). However, there has been little information on the QoL of parents of children with ASD in the Jordanian context.

Objective:
This study aimed to assess the QoL among mothers and fathers who have children with ASD in Jordan and to identify factors associated with it.

Methods:
In this cross-sectional study, respondents were mothers and fathers of children with ASD attending autism rehabilitation centers in Amman. Data were collected from 206 participants using a validated questionnaire. Descriptive statistics, T-test, ANOVA and logistic regression, were applied.

Results:
Overall quality of life was low (mean= 2.32). The physical dimension scored the highest (mean =2.79), and the environmental dimension scored the lowest (mean= 2.06). Results indicated that fathers and parents with low education reported significantly lower QoL scores (p = .024 and 0.001, respectively).

Conclusion:
Among parents of children with ASD, parents at risk for low QoL were recognized. Our results can be utilized to design interventions to support mothers and fathers at risk in Jordan to enhance their QoL.
Burnout among Brazilian Dentists during the COVID-19 Pandemic: A Cross-sectional Study
Authors: Silva Juliane Kely F. , Carvalho Fernando M. , Azevedo Carolina F. , Silva Marcos Vinicius S. , Lima Arthur Igor C. , Lins-Kusterer Liliane 
Published: August 2023

Background:
This article identifies the factors associated with burnout among dentists in the state of Bahia, Brazil, during the COVID-19 pandemic.

Methods:
A cross-sectional study, conducted between November 2020 and February 2021, of 251 dentists, selected by snowball sampling. Sociodemographic, occupational, and epidemiological information was collected in an electronic form. Burnout was evaluated through the Maslach Burnout Inventory; anxiety through the Beck Anxiety Inventory; and quality of life through the WHOQol-BREF questionnaire. Multiple linear regression was used to identify factors associated with variations in levels of the three burnout dimensions.

Results:
The mean levels of the burnout dimensions were: Emotional Exhaustion: 28.9 ± 8.9 (SD); Depersonalization = 8.2 ± 6.3; and Personal Accomplishment: 28.0 ± 6.2. The proportion of professionals with high Emotional Exhaustion (≥ 30 cut-off score), high Depersonalization (≥ 12 cut-off score), and low Personal Accomplishment (≤ 33 cut-off score) were 43.4%, 26.3% and 81.3%, respectively. Burnout components were associated with high anxiety; lower levels of the physical, psychological, social relations, and environmental dimensions of quality of life; less time working as a dentist; increased alcohol consumption during the pandemic, feeling safe when using personal protective equipment, and support from work fellows.

Conclusion:
The dentists investigated showed moderate levels of Emotional Exhaustion and Depersonalization, and very low levels of Personal Accomplishment. The prevention and mitigation of burnout syndrome among dentists during a pandemic should consider several factors, such as quality of life, amount of time in the profession, use of personal protective equipment, support from fellow dentists, and alcohol consumption.
Venetoclax Synergizes Sunitinib in Renal Cell Carcincoma through Inhibition of
Bcl-2
Authors: Tang Yuanjia , Song Tao , Gao Liangkui , Mao Fei 
Published: August 2023

Aims:
More effective treatment options for patients with renal cell carcinoma (RCC) are needed, in particular
advanced RCC.

Background:
Sunitinib, a multitarget tyrosine kinase inhibitor, is a first-line treatment of metastatic RCC. However, the
management of sunitinib-induced adverse events and resistance is complex. In hematological malignancies, effective targeting
of anti-apoptotic proteins such as Bcl-2 has been achieved, but limited progress has been made in solid tumors.

Objective:
This work systematically investigated the therapeutic potential of the combination of sunitinib and venetoclax,
a Bcl-2 inhibitor, in preclinical RCC models.

Methods:
Quantitative analysis of drug interactions was performed. Cell viability was examined after drug treatment or
Bcl-2 siRNA depletion. RCC xenograft mouse model was applied to validate the efficacy of sunitinib and venetoclax.

Results:
A strong synergistic interaction between sunitinib and venetoclax was observed across a range of different dose
levels in all tested RCC cell lines. Sequential treatment studies show that the sequential addition of venetoclax and then
sunitinib is superior to concurrent treatment and the sequential addition of sunitinib and then venetoclax in decreasing
RCC cell viability. The sensitivity of RCC cell lines to venetoclax treatment negatively correlates with their Bcl-2
levels. Specific depletion of Bcl-2 mimics the synergistic effects of venetoclax with sunitinib. Treatment of mice implanted
with high Bcl-2-expressing RCC cells reveals that a combination of venetoclax and sunitinib at a non-toxic
dose displays complete regression of tumor growth throughout the whole duration of treatment.

Conclusion:
Our work demonstrates that inhibiting Bcl-2 by venetoclax synergistically enhances sunitinib’s efficacy in
RCC. Venetoclax holds great potential as a viable option for clinical use.
Effects of Virtual Reality Exercises on Chronic Low Back Pain: Quasi-Experimental Study
Authors: Afzal M Waqar , Ahmad Ashfaq , Hanif Hafiz Muhammad Bilal , Chaudhary Nauman , Gilani Syed Amir 
Published: August 2023

Background
Low back pain is a common health problem globally. Based on the duration of pain, it is classified as acute, subacute, or chronic low back pain. Different treatment strategies are available to reduce chronic low back pain. Virtual reality (VR) is a novel approach in back pain rehabilitation.

Objective
This study aimed to compare the effects of VR games on chronic low back pain.

Methods
This quasi-experimental study was conducted among 40 patients with chronic low back pain. The data were collected using a nonprobability, convenient sampling technique. Patients visiting the Department of Physiotherapy, Government Services Hospital, Lahore, Pakistan, were recruited and equally divided into 4 groups. Group A received the Reflex Ridge game; group B received the Body Ball game; group C combined the 2 games without back-strengthening exercises; and group D combined the 2 games with back-strengthening exercises. The participants received 8 treatment sessions, with 3 sessions/wk. The outcomes were pre- and posttest measurements of pain intensity, low back disability, and lumbar range of motion. The repeated measurement ANOVA was used for inter- and intragroup comparison, with significance at P≤.05.

Results
The study comprised a sample of 40 patients with low back pain; 12 (40%) were female and 28 (60%) were male, with a mean age of 37.85 (SD 12.15) years. The pre- and posttest mean pain scores were 7.60 (SD 1.84) and 4.20 (SD 1.62) in group A, 6.60 (SD 1.776) and 5.90 (SD 1.73) in group B, 6.90 (SD 1.73) and 5.40 (SD 1.07) in group C, and 7.10 (SD 1.53) and 3.60 (SD 0.97) in group D, respectively. The mean pain score differences of group D (combining the Reflex Ridge and Body Ball games with back-strengthening exercises) compared to groups A, B, and C were –.60 (P=.76), –2.30 (P<.001), and –1.80 (P=.03), respectively. Regarding the range of motion, the forward lumbar flexion mean differences of group D compared to groups A, B, and C were 3.80 (P=.21), 4.80 (P=.07), and 7.40 (P<.001), respectively. Similarly, the right lateral lumbar flexion mean differences of group D compared to groups A, B, and C were 2.80 (P=.04), 5.20 (P<.001), and 4.80 (P<.001), respectively. The left lateral lumbar flexion mean differences of group D compared to groups A, B, and C were 2.80 (P<.001), 4.80 (P=.02), and 2.20 (P<.001). respectively, showing significant pre- and posttreatment effects.

Conclusions
VR exercises had statistically significant effects on improving pain, low back disability, and range of motion in all groups, but the combination of Reflex Ridge and Body Ball games with back-strengthening exercises had dominant effects compared to the other groups.

Trial Registration
Iranian Registry of Clinical Trial IRCT20200330046895N1; https://en.irct.ir/trial/46916
Users’ Concerns About Endometriosis on Social Media: Sentiment Analysis and Topic Modeling Study
Authors: Goel Rahul , Modhukur Vijayachitra , Täär Katrin , Salumets Andres , Sharma Rajesh , Peters Maire 
Published: August 2023

Background
Endometriosis is a debilitating and difficult-to-diagnose gynecological disease. Owing to limited information and awareness, women often rely on social media platforms as a support system to engage in discussions regarding their disease-related concerns.

Objective
This study aimed to apply computational techniques to social media posts to identify discussion topics about endometriosis and to identify themes that require more attention from health care professionals and researchers. We also aimed to explore whether, amid the challenging nature of the disease, there are themes within the endometriosis community that gather posts with positive sentiments.

Methods
We retrospectively extracted posts from the subreddits r/Endo and r/endometriosis from January 2011 to April 2022. We analyzed 45,693 Reddit posts using sentiment analysis and topic modeling–based methods in machine learning.

Results
Since 2011, the number of posts and comments has increased steadily. The posts were categorized into 11 categories, and the highest number of posts were related to either asking for information (Question); sharing the experiences (Rant/Vent); or diagnosing and treating endometriosis, especially surgery (Surgery related). Sentiment analysis revealed that 92.09% (42,077/45,693) of posts were associated with negative sentiments, only 2.3% (1053/45,693) expressed positive feelings, and there were no categories with more positive than negative posts. Topic modeling revealed 27 major topics, and the most popular topics were Surgery, Questions/Advice, Diagnosis, and Pain. The Survey/Research topic, which brought together most research-related posts, was the last in terms of posts.

Conclusions
Our study shows that posts on social media platforms can provide insights into the concerns of women with endometriosis symptoms. The analysis of the posts confirmed that women with endometriosis have to face negative emotions and pain daily. The large number of posts related to asking questions shows that women do not receive sufficient information from physicians and need community support to cope with the disease. Health care professionals should pay more attention to the symptoms and diagnosis of endometriosis, discuss these topics with patients to reduce their dissatisfaction with doctors, and contribute more to the overall well-being of women with endometriosis. Researchers should also become more involved in social media and share new science-based knowledge regarding endometriosis.
Relationship Factors in Internet-Delivered Psychological Interventions for Veterans Experiencing Postpartum Depression: Qualitative Analysis
Authors: Solness Cara L , Holdefer Paul J , Hsu Ti , Thomas Emily B K , O'Hara Michael W 
Published: August 2023

Background
Internet-delivered psychological interventions (IPIs) have been shown to be effective for a variety of psychological concerns, including postpartum depression. Human-supported programs produce better adherence and larger effect sizes than unsupported programs; however, what it is about support that affects outcomes is not well understood. Therapeutic alliance is one possibility that has been found to contribute to outcomes; however, the specific mechanism is not well understood. Participant perspectives and qualitative methodology are nearly absent from the IPI alliance research and may help provide new directions.

Objective
In this study, we aimed to provide participant perspectives on engagement with an IPI for postpartum depression to help inform alliance research, development of new IPIs, and inform resource allocation.

Methods
A qualitative methodology was used to explore participant perspectives of veteran women’s engagement with the MomMoodBooster program, a human-supported internet-delivered intervention for postpartum depression. Participants were asked 4 open-ended questions with the 3-month postintervention survey, “In what ways did you find the MomMoodBooster most helpful?” “How do you think the MomMoodBooster could have been improved?” “In what ways did you find the personal coach calls to be helpful?” and “How do you think the personal coach calls could have been improved?”

Results
Data were collected from 184 participants who responded to at least 1 of the open-ended questions. These were analyzed using thematic analysis and a process of reaching a consensus among coders. The results suggest that not only the engagement with the support person is perceived as a significant contributor to participant experiences while using the MomMoodBooster content but also the relationship factors are particularly meaningful. The results provide insights into the specific qualities of the support person that were perceived as most impactful, such as warmth, empathy and genuineness, and feeling normalized and supported. In addition, the results provide insight into the specific change processes that can be targeted through support interactions, such as encouraging self-reflection and self-care and challenging negative thinking.

Conclusions
These data emphasize the importance of relationship factors between support persons and an IPI program for postpartum depression. The findings suggest that focusing on specific aspects of the alliance and the therapeutic relationship could yield fruitful directions for the training of support personnel and for future alliance-based research of internet-delivered treatments.
Mucocutaneous Manifestations Among HIV-Infected Patients in Madagascar: Cross-Sectional Study
Authors: Sendrasoa Fandresena Arilala , Falimiarintsoa Volatiana Mercia , Ramarozatovo Lala Soavina , Rapelanoro Rabenja Fahafahantsoa 
Published: August 2023

Background
More than 90% of HIV-infected patients present with at least one mucocutaneous manifestation during the course of their disease. Insufficient data are available regarding dermatologic findings among HIV-infected patients in Madagascar.

Objective
This study aimed at evaluating the spectrum of mucocutaneous manifestations and their relationship with CD4 cell counts in HIV-infected patients in Madagascar.

Methods
A cross-sectional study on HIV-positive patients attending the Department of Infectious Diseases in the University Hospital of Antananarivo in Madagascar was conducted from January 2013 to March 2020. HIV-positive patients older than 18 years and receiving antiretroviral therapy as well as those awaiting antiretroviral therapy commencement were included.

Results
Among 328 patients enrolled in this study, 167 (51%) presented with at least one type of mucocutaneous lesion. Oral candidiasis was the most common presentation, followed by seborrheic dermatitis and Kaposi sarcoma. Decreases in CD4 cell counts were substantially correlated with oral candidiasis, syphilis, and condyloma acuminatum.

Conclusions
According to our findings, oral candidiasis, syphilis, and condyloma acuminatum may serve as clinical indicators for predicting the immune status of patients. As HIV infection progressed and immune function declined, an increase in cutaneous manifestations was observed.
Skin-Lightening Product Use Among South Asian Americans: Cross-Sectional Survey Study
Authors: Banala Manisha , Mamidipaka Anusha , Ogunleye Temitayo 
Published: August 2023

Background
Despite their potential for adverse health effects, skin-lightening products remain popular among South Asian Americans.

Objective
This study investigates attitudes toward skin tone and the prevalence and adverse effects of skin-lightening product use among South Asian Americans.

Methods
We conducted a cross-sectional study, recruiting and surveying 175 women or nonbinary individuals meeting the following inclusion criteria: (1) lived in the United States, (2) identified as South Asian, and (3) were raised by parents born in South Asian countries.

Results
Of the 175 participants, 55 (31%) respondents used a skin-lightening product before. Parental pressure to use skin-lightening products and decreased time spent in the United States were significantly associated with skin-lightening product use (odds ratio [OR] 8.51, 95% CI 3.33-21.78, P<.001, and OR 0.70, 95% CI 0.52-0.96, P=.03, respectively). Although only 6 of the 55 (11%) users reported being aware of the potential side effects of skin-lightening products, 33 (60%) reported adverse effects, with acne, skin sensitivity, and dry skin being the most common. Users and nonusers equally endorsed statements associating lighter skin with increased attractiveness (P=.31), marriageability (P=.94), social status (P=.98), self-esteem (P=.73), and respect received from others (P=.74).

Conclusions
The use of skin-lightening products among South Asian Americans is common and linked to social and psychological factors. Parental pressure and cultural beauty standards may play a significant role in perpetuating this practice. This study highlights the need for educational campaigns about the potential health risks associated with skin-lightening and increased efforts to challenge harmful beauty standards.
STUDI REDUKSI GRAPHENE OXIDE SECARA KIMIA DENGAN MENGGUNAKAN ASCORBIC ACID YANG RAMAH LINGKUNGAN
Authors: FITHRI HAFIDHEA LUTHFIANA , FITRILAWATI F , SYAKIR NORMAN 
Published: August 2023

Untuk keperluan aplikasi banyak digunakan graphane oxide (GO) sebagai prekursor guna menghasilkan graphene like material yang dikenal sebagai reduced graphene oxide (rGO). Untuk menghasilkan rGO dalam jumlah besar sering dipergunakan proses reduksi secara kimia. Sejauh ini banyak digunakan senyawa hydrazine sebagai agen pereduksi untuk menghasilkan rGO, namun senyawa hydrazine sangat berbahaya bagi lingkungan. Telah dilaporkan penggunaan ascorbic acid (AA) sebagai agen pereduksi yang ramah lingkungan untuk menghasilkan rGO. Dalam penelitian ini dikaji proses reduksi secara kimia dengan menggunakan ascorbic acid. Perbandingan konsentrasi antara GO dan AA yang digunakan adalah 1:10. Pertama disiapkan dispersi GO dengan konsentrasi 0,2 mg/mL dan larutan AA dengan konsentrasi 2 mg/mL. Selanjutnya dispersi GO dan larutan AA dicampurkan dan dilakukan pengadukan selama 24 jam pada suhu . Hasil pengukuran dengan spectroscopy UV-Vis memperlihatkan nilai energi gap GO sebesar 3,36 eV menurun menjadi 2,72 eV menjadi rGO setelah dikenakan proses reduksi. Spektrum Fourier-Transform Infrared (FTIR) dari rGO dibandingkan dengan GO menunjukkan adanya penurunan intensitas gugus O-H, C-H, C=O, C-O, dan C-O-C. Selain itu hasil pengukuran EDS menunjukkan rasion C/O berubah dari 44% menjadi 26,729% setelah dilakukan proses reduksi. Hasil pengukuran XRD menunjukkan sampel rGO memiliki nilai di 27,873 Dengan jarak interlayernya 3,198 Kata kunci: reduced graphene oxide, ascorbic acid, ramah lingkungan