bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a machine learning-based detection system to improve precision screening for medication errors in the neonatal intensive care unit
Authors: Yalçın Nadir , Kaşıkcı Merve , Çelik Hasan Tolga , Allegaert Karel , Demirkan Kutay , Yiğit Şule , Yurdakök Murat 
Published: April 2023

Aim: To develop models that predict the presence of medication errors (MEs) (prescription, preparation, administration, and monitoring) using machine learning in NICU patients.Design: Prospective, observational cohort study randomized with machine learning (ML) algorithms.Setting: A 22-bed capacity NICU in Ankara, Turkey, between February 2020 and July 2021.Results: A total of 11,908 medication orders (28.9 orders/patient) for 412 NICU patients (5.53 drugs/patient/day) who received 2,280 prescriptions over 32,925 patient days were analyzed. At least one physician-related ME and nurse-related ME were found in 174 (42.2%) and 235 (57.0%) of the patients, respectively. The parameters that had the highest correlation with ME occurrence and subsequently included in the model were: total number of drugs, anti-infective drugs, nervous system drugs, 5-min APGAR score, postnatal age, alimentary tract and metabolism drugs, and respiratory system drugs as patient-related parameters, and weekly working hours of nurses, weekly working hours of physicians, and number of nurses’ monthly shifts as care provider-related parameters. The obtained model showed high performance to predict ME (AUC: 0.920; 95% CI: 0.876–0.970) presence and is accessible online (http://softmed.hacettepe.edu.tr/NEO-DEER_Medication_Error/).Conclusion: This is the first developed and validated model to predict the presence of ME using work environment and pharmacotherapy parameters with high-performance ML algorithms in NICU patients. This approach and the current model hold the promise of implementation of targeted/precision screening to prevent MEs in neonates.Clinical Trial Registration:ClinicalTrials.gov, identifier NCT04899960.
Study on the liver Drug’s dominant metabolic enzymes for six effective components of the Huang qi Liuyi decoction
Authors: Wang Qun , Tang Tiantian , Wu Zengguang , Yang Hong , Gao Yuan , Zhang Shiyu , Song Xinli , Chen Xiaolan 
Published: April 2023

Objective: To investigate the dominant metabolic enzymes of six effective components (astragaloside IV, glycyrrhizic acid, calycosin-glucuronide, formononetin, ononin, calycosin-7-O-β-D- glucoside) of Huangqi Liuyi decoction extract (HQD).Methods: Mouse liver microsomes were prepared. The effects of specific inhibitors of CYP450 enzymes on the metabolism of six effective components of HQD were studied using liver microsomal incubation in vitro.Results: The chemical inhibitors of CYP2C37 inhibit the metabolism of glycyrrhizic acid and astragaloside IV. Formononetin and astragaloside IV metabolism is inhibited by the chemical inhibitors of CYP2C11. The chemical inhibitors of CYP2E1 and CYP1A2 inhibit the metabolism of calycosin-glucuronide. Chemical CYP3A11 inhibitors prevent formononetin and glycyrrhizic acid from being metabolized. However, no inhibitor significantly affected the metabolism of ononin and calycosin-7-O-β-D-glucoside.Conclusion: CYP2C37 may be involved in the metabolism of astragaloside IV and glycyrrhizic acid, the metabolism of astragaloside IV and formononetin may be related to CYP2C11, the metabolism of calycosin-glucuronide may be related to CYP1A2 and CYP2E1, and CYP3A11 may be involved in the metabolism of glycyrrhizic acid and formononetin. This research provides an experimental basis for exploring the pharmacokinetic differences caused by metabolic enzymes.
Introduction of managed entry agreements in Korea: Problem, policy, and politics
Authors: Kim Hyungmin , Godman Brian , Kwon Hye-Young , Hong Song Hee 
Published: April 2023

Objectives: This study aimed to understand Managed Entry Agreements (MEAs) in Korea through the framework of three streams of the policy window model and its practical management and impact on pricing and reimbursement scheme.Methods: An extensive literature review based on Kingdon’s model was conducted. We also performed descriptive analyses of MEA implementation using data on medicines listed in Korea and compared its MEA scheme with four different countries.Results: As per problem streams, patients with rare disease or cancers have considerable difficulties in affording their medicines and this has challenged the drug benefit system and raised an issue of patient’s access. Policy streams highlighted that MEAs were introduced as a benefit enhancement plan for four major diseases since January 2014. MEAs have also been strengthened as a bypass mechanism to expand the insurance coverage especially for new premium-priced medicines under Moon Care (Listing all non-listed services). In descriptive analysis of MEAs, a total of 48 medicines were contracted as MEAs from January 2014 to December 2020, accounting for 73.4% of listed medicines for cancer or rare diseases and 97.9% of the cases were finance-based contracts. Meanwhile, outcome-based contracts such as CED accounted for only 2.1%. The application of MEAs differs across countries, resulting in a kappa coefficient of 0.00–0.14 (United Kingdom 0.03, Italy 0.00, Australia 0.14), indicating a lack of consistency compared to South Korea.Conclusion: MEAs, which were introduced as a bypass mechanism, have now superseded the standard process for anticancer agents or orphan drugs. Further studies are needed to evaluate the impact of the confidential agreements and effectiveness of new high-priced medicines with limited clinical data at launch.
Heart rate variability in different sleep stages is associated with metabolic function and glycemic control in type 2 diabetes mellitus
Authors: Cheng Wenquan , Chen Hongsen , Tian Leirong , Ma Zhimin , Cui Xingran 
Published: April 2023

Introduction: Autonomic nervous system (ANS) plays an important role in the exchange of metabolic information between organs and regulation on peripheral metabolism with obvious circadian rhythm in a healthy state. Sleep, a vital brain phenomenon, significantly affects both ANS and metabolic function.Objectives: This study investigated the relationships among sleep, ANS and metabolic function in type 2 diabetes mellitus (T2DM), to support the evaluation of ANS function through heart rate variability (HRV) metrics, and the determination of the correlated underlying autonomic pathways, and help optimize the early prevention, post-diagnosis and management of T2DM and its complications.Materials and methods: A total of 64 volunteered inpatients with T2DM took part in this study. 24-h electrocardiogram (ECG), clinical indicators of metabolic function, sleep quality and sleep staging results of T2DM patients were monitored.Results: The associations between sleep quality, 24-h/awake/sleep/sleep staging HRV and clinical indicators of metabolic function were analyzed. Significant correlations were found between sleep quality and metabolic function (|r| = 0.386 ± 0.062, p &lt; 0.05); HRV derived ANS function showed strengthened correlations with metabolic function during sleep period (|r| = 0.474 ± 0.100, p &lt; 0.05); HRV metrics during sleep stages coupled more tightly with clinical indicators of metabolic function [in unstable sleep: |r| = 0.453 ± 0.095, p &lt; 0.05; in stable sleep: |r| = 0.463 ± 0.100, p &lt; 0.05; in rapid eye movement (REM) sleep: |r| = 0.453 ± 0.082, p &lt; 0.05], and showed significant associations with glycemic control in non-linear analysis [fasting blood glucose within 24 h of admission (admission FBG), |r| = 0.420 ± 0.064, p &lt; 0.05; glycated hemoglobin (HbA1c), |r| = 0.417 ± 0.016, p &lt; 0.05].Conclusions: HRV metrics during sleep period play more distinct role than during awake period in investigating ANS dysfunction and metabolism in T2DM patients, and sleep rhythm based HRV analysis should perform better in ANS and metabolic function assessment, especially for glycemic control in non-linear analysis among T2DM patients.
More than words: Speech production in first-episode psychosis predicts later social and vocational functioning
Authors: Mackinley Michael , Limongi Roberto , Silva Angélica María , Richard Julie , Subramanian Priya , Ganjavi Hooman , Palaniyappan Lena 
Published: April 2023

BackgroundSeveral disturbances in speech are present in psychosis; however, the relationship between these disturbances during the first-episode of psychosis (FEP) and later vocational functioning is unclear. Demonstrating this relationship is critical if we expect speech and communication deficits to emerge as targets for early intervention.MethodWe analyzed three 1-min speech samples using automated speech analysis and Bayes networks in an antipsychotic-naive sample of 39 FEP patients and followed them longitudinally to determine their vocational status (engaged or not engaged in employment education or training—EET vs. NEET) after 6–12 months of treatment. Five baseline linguistic variables with prior evidence of clinical relevance (total and acausal connectives use, pronoun use, analytic thinking, and total words uttered in a limited period) were included in a Bayes network along with follow-up NEET status and Social and Occupational Functioning Assessment Scale (SOFAS) scores to determine dependencies among these variables. We also included clinical (Positive and Negative Syndrome Scale 8-item version (PANSS-8)), social (parental socioeconomic status), and cognitive features (processing speed) at the time of presentation as covariates.ResultsThe Bayes network revealed that only total words spoken at the baseline assessment were directly associated with later NEET status and had an indirect association with SOFAS, with a second set of dependencies emerging among the remaining linguistic variables. The primary (speech-only) model outperformed models including parental socioeconomic status, processing speed or both as latent variables.ConclusionImpoverished speech, even at subclinical levels, may hold prognostic value for functional outcomes and warrant consideration when providing measurement based care for first-episode psychosis.
Case series: Cariprazine in early-onset schizophrenia
Authors: Ivanova Elena , Maslinkova Desislava , Polnareva Nadia , Milanova Vihra 
Published: April 2023

IntroductionNegative symptoms are part of the clinical manifestations of schizophrenia and their presence is associated with a poorer prognosis, significantly limited vocational opportunities, impaired quality of life and social functioning. In the clinical practice, treatment of negative symptoms in patients with schizophrenia, is a challenge. Cariprazine is a novel partial agonist of D3 and D2 receptors, and shows a high affinity for D3, with good tolerability, good response to schizophrenic symptoms and limited side effects. We present two cases of young patients with predominantly negative symptoms during treatment with an atypical antipsychotic, administered in a stable dose and therapeutic range, and for at least 4 weeks prior to the Cariprazine switch.MethodsTwo patients (men aged 21 and 22) with schizophrenia, exhibiting predominantly negative symptoms, are presented. Their diagnosis was based on, DSM-5 criteria (295.10).Patients were treated with Cariprazine at a daily dose of 4.5 mg. They were followed for a period of 18 months and assessed with Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF) and Clinical Global Impression-Severity (CGI-S), at the fourth week of initiation of treatment with Cariprazine, at 6 months, at 12 months and at 18 months. Their mean initial value was 75.5 on PANSS, 4.0 on CGI-S, and 52.5 on GAF. Both patients were treated with stable doses of atypical antipsychotic–Risperidone at a daily dose of 4,5 mg. Cross-titration to Cariprazine was initiated, from 1.5 mg daily dose up to 4,5 mg daily dose, during a period of 2 weeks.ResultsAfter 18 months of treatment with Cariprazine at a daily dose of 4.5 mg, the following results were reported: mean value was 57.5 on PANSS, 3.0 on CGI-S, and 74.5 on GAF. The overall PANSS mean score decreased by 23.8%, the CGI-S mean score improved by 25% and the mean GAF score increased by 29.5%. The positive PANSS subscale score decreased minimally, from 20 to 16, while for the negative subscale the improvement was 29.8%.Cariprazine was well tolerated by patients and no side effects were observed from it during therapy.DiscussionAfter 18 months Cariprazine succeeded in improving negative symptoms, global functioning, and global clinical impression. In young schizophrenic patients with a predominance of negative symptoms, the cariprazine may be a successful alternative.
A propensity score matching study: The prevalence of mental health problems among pregnant women at first antenatal care increased in Chongqing during the first wave of the COVID-19 pandemic
Authors: Guo Jiamei , Li Xiao , He Jinglan , Ai Ming , Gan Yao , Zhang Qi , Zheng Anhai , Chen Wanjun , Chen Lulu , Liang Sisi , Yu Xiaoyu , Kuang Li 
Published: April 2023

BackgroundThe 2019 coronavirus disease (COVID-19) pandemic increased the risks of mental health challenges, especially anxiety and depression. However, the impact of COVID-19 on mental health during pregnancy has not been fully established. Therefore, we investigated the impact of the COVID-19 pandemic on maternal mental health.MethodsTwo cohorts of pregnant women at their first antenatal care in the First Affiliated Hospital of Chongqing Medical University were enrolled in this study. One cohort was enrolled before the COVID-19 outbreak, from 1 June to 31 December 2019 (n = 5,728, pre-COVID-19 group), while the other was enrolled during the COVID-19 pandemic, from 24 January to 23 March 2020 (n = 739, COVID-19 pandemic group). Symptoms of depression, anxiety, and somatization disorders were assessed by the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-15 (PHQ-15), with a cutoff point of 10 for moderate-to-severe depression, anxiety, and somatoform symptoms. The propensity score matching method (1:1) was used to balance differences in demographic characteristics between groups. A chi-square analysis was performed to compare differences in demographic characteristics between the groups.ResultsPrevalence of moderate-to-severe depression, anxiety, and somatoform symptoms among pregnant women at their first antenatal care visit during the COVID-19 pandemic (9.5, 2.2, and 20.8%, respectively) was significantly lower than those before the pandemic (16.3, 4.4, and 25.7%, respectively) (p &lt; 0.05). Compared with the same period before the pandemic, during the pandemic, the number of women newly registered for antenatal care decreased by nearly 50%. There were significant differences in the distributions of demographic characteristics between the groups (p &lt; 0.05). After matching the demographic characteristics, differences in the prevalence of maternal mental health disorders between the groups reversed dramatically. Prevalence of moderate-to-severe depression, anxiety, and somatoform symptoms during the COVID-19 pandemic in this population (2.3, 9.6, and 20.8%, respectively) was significantly higher than those before the pandemic (0.3, 3.9, and 10%, respectively) (p &lt; 0.05).ConclusionThe COVID-19 pandemic increased mental health risks among pregnant women. As a large proportion of pregnant women with mental health challenges delay their prenatal care or change healthcare facilities after the outbreak of public health emergencies, there is a need to establish a balanced healthcare system in medical institutions at all levels.
Aggressive behavior in adolescent: The importance of biopsychosocial predictors among secondary school students
Authors: Fauzi Fatimah Ahmad , Zulkefli Nor Afiah Mohd , Baharom Anisah 
Published: April 2023

IntroductionOvert aggression is a common type of aggression observed among adolescents, which is apparent and outward confrontational acts manifested physically and verbally, such as fighting and shouting. It has become a major public health concern, as it results in detrimental health impacts like injury, mental health, and social problems.MethodsAn observational study was conducted among 16-year-old school students to determine their biopsychosocial predictors, using stratified proportionate population sampling. Pre-tested surveys were distributed to measure students’ aggression, biological, psychological, and social factors.ResultsA total of 463 students from four public secondary schools participated in the study, with a median aggression score was 23.00 (IQR=12.00). The significant predictors of aggression from multivariate analysis were Malay race, frequent dessert intakes, attitude towards aggression, low family income, and peer deviant affiliation (F [8, 244] = 15.980, p &lt; 0.001, adjusted R2 = 0.290).DiscussionAdolescent aggression determinants are collectively impacted as a result of biological, psychological, and social predictors and need to be focused on in interventional strategies.
Phase-Resolved Optical Coherence Elastography: An Insight into Tissue Displacement Estimation
Authors: Batista Ana , Serranho Pedro , Santos Mário J. , Correia Carlos , Domingues José P. , Loureiro Custódio , Cardoso João , Barbeiro Sílvia , Morgado Miguel , Bernardes Rui 
Published: April 2023

Robust methods to compute tissue displacements in optical coherence elastography (OCE) data are paramount, as they play a significant role in the accuracy of tissue elastic properties estimation. In this study, the accuracy of different phase estimators was evaluated on simulated OCE data, where the displacements can be accurately set, and on real data. Displacement (∆d) estimates were computed from (i) the original interferogram data (Δφori) and two phase-invariant mathematical manipulations of the interferogram: (ii) its first-order derivative (Δφd) and (iii) its integral (Δφint). We observed a dependence of the phase difference estimation accuracy on the initial depth location of the scatterer and the magnitude of the tissue displacement. However, by combining the three phase-difference estimates (Δdav), the error in phase difference estimation could be minimized. By using Δdav, the median root-mean-square error associated with displacement prediction in simulated OCE data was reduced by 85% and 70% in data with and without noise, respectively, in relation to the traditional estimate. Furthermore, a modest improvement in the minimum detectable displacement in real OCE data was also observed, particularly in data with low signal-to-noise ratios. The feasibility of using Δdav to estimate agarose phantoms’ Young’s modulus is illustrated.
Morphological structure and composition of an odontoma removed from a 7-year-old child: a clinical case
Authors: Pikhur O. L. , Tishkov D. S. , Grechikhin S. S. , Gromov A. L. , Plotkina Yu. V. , Kulkov A.  M. 
Published: April 2023

Relevance. An odontoma is a benign odontogenic tumour that consists of dental tissue elements. Diagnosis and differential diagnosis of odontomas is complicated enough for their high heterogeneity and significant morphological inhomogeneity.Clinical case description. The article presents the results of studying the morphology and composition of odontoma removed surgically for medical reasons in a 7-year-old patient using a complex of the following research methods: optical microscopy, scanning electron microscopy, X-ray computed microtomography and microprobe analysis. The study established that the odontoma belongs to solid simple odontoma. The odontoma is 0.93 х 0.63 х 0.45 cm in size and formed by dentin covered with an uneven layer of the irregular enamel surface. The microtomography provided the odontoma's internal structure 3D model demonstrating a conical cavity formed by the hard dental tissues. The chemical composition of odontoma contains significant amounts of calcium, phosphorus, sodium, magnesium, and chlorine. The Ca/P-coefficient in dentin is 1.44, and in enamel – 1.66-1.68.Conclusion. The study results contribute to the odontoma causes and pathogenesis investigation and form the base for the pathology diagnosis and implementation of treatment and preventive measures.
Analysis of Social Return on Investment (SROI) on Social Innovation of Superman Sumanding
Authors: Anam A. Khoirul , Arifin Miftah , Mahaputra Wahyu , Agus Prasetiyo Riyan 
Published: April 2023

Objective: This study aims to evaluate the value of the impact generated from CSR programs on the implementation of Superman Sumanding's social innovation. In this approach, the program's effect has an essential meaning for the program's beneficiaries, namely the farming community groups in Sumanding Village. Research Design & Methods: This study used Social Return on Investment (SROI) as a research methodology. This research was conducted on the beneficiaries of the Superman Sumanding program and has considered all stakeholders directly or indirectly involved in the program. The research informants were 37, with details of 17 members of the Sumanding Village 'Guyub Rukun' Farmer Group and the Sumanding Village 'Karya Mukti' Peasant Women's Group of 20 people. Findings: The results show the SROI value of IDR9.19:1. This means that the CSR program carried out has been able to provide benefits of 9.19 times greater than the value of the inputs invested. The results showed that the CSR program run by PT PLN UIK TJB produced social returns on investment and provided economic, social, and environmental benefits. Implications & Recommendations: SROI as a solution that changes the mindset of investment analysis is based on outcomes rather than just outputs. A sound output does not necessarily deliver as expected, as focusing on the outcome will provide a better and more comprehensive perspective. The results of the SROI analysis become the basis for improving the planning of subsequent CSR programs. Contribution & Value Added: This study allows us to expand the evidence of the critical role of social innovation for peasant community groups, but so far, little studied and areas of application of SROI as an assessment methodology.
АДМІНІСТРАТИВНА ПАРАДИГМА ПУБЛІЧНОГО УПРАВЛІННЯ ПІД ЧАС ЗНАХОДЖЕННЯ КРАЇНИ В СТАНІ ВІЙНИ ТА ПІСЛЯВОЄННИЙ ЧАС
Authors: Попов Микола 
Published: April 2023

Військова агресія Росії спочатку проти Молдови та Грузії, а починаючи з 2014 року і проти України поставила на порядку денному як для цих країн, так і загалом для всього світу питання розробки нової адміністративної парадигми управління державою за умов кризи. Її визначальною особливістю має стати урахування зовнішніх та внутрішніх деструктивних факторів впливу, адаптація до змін середовища з одночасним спрямування на забезпечення ефективного сталого розвитку регіону.