bluuebunny/crossref_metadata_2025_split huggingface dataset:
Artificial intelligence-supported web application design and development for reducing polypharmacy side effects and supporting rational drug use in geriatric patients
Authors: Akyon Seyma Handan , Akyon Fatih Cagatay , Yılmaz Tarık Eren 
Published: March 2023

IntroductionThe main complications of polypharmacy, which is known as the simultaneous use of more than five drugs, are potentially inappropriate medicines(PIMs), drug–drug, and drug-disease interaction. It is aimed to prepare an auxiliary tool to reduce the complications of polypharmacy and to support rational drug use(RDU), by evaluating the patient with age, drugs, and chronic diseases in this study.Materials and methodsIn the first phase of this study, as methodological research, an up-to-date and comprehensive auxiliary tool as a reference method was generated with a database containing interaction information of 430 most commonly used drug agents and chronic diseases in geriatrics in the light of current and valid 6 PIM criteria for geriatric patients, and medication prospectuses, relevant current articles, and guidelines. Then, an artificial intelligence(AI) supported web application was designed and developed to facilitate the practical use of the tool. Afterward, the data of a cross-sectional observational single-center study were used for the rate and time of PIM and drug interaction detection with the web application. The proposed web application is publicly available at https://fastrational.com/.ResultsWhile the PIM coverage rate with the proposed tool was 75.3%, the PIM coverage rate of EU(7)-PIM, US-FORTA, TIME-to-STOPP, Beers 2019, STOPP, Priscus criteria in the web application database respectively(63.5%–19.5%) from the highest to the lowest. The proposed tool includes all PIMs, drug–drug, and drug-disease interaction information detected with other criteria. A general practitioner detects interactions for a patient without the web application in 2278 s on average, while the time with the web application is decreased to 33.8 s on average, and this situation is statistically significant.DiscussionIn the literature and this study, the PIM criteria alone are insufficient to include actively used medicines and it shows heterogeneity. In addition, many studies showed that the biggest obstacle to drug regulation in practice is “time constraints.” The proposed comprehensive auxiliary tool analyzes age, drugs, and diseases specifically for the patient 60 times faster than the manual method, and it provides quick access to the relevant references, and ultimately supports RDU for the clinician, with the first and only AI-supported web application.
Cortical activation and functional connectivity during locomotion tasks in Parkinson’s disease with freezing of gait
Authors: Feng HongSheng , Jiang YanNa , Lin JinPeng , Qin WenTing , Jin LingJing , Shen Xia 
Published: March 2023

BackgroundFreezing of gait (FoG) is a severely disabling symptom in Parkinson’s disease (PD). The cortical mechanisms underlying FoG during locomotion tasks have rarely been investigated.ObjectivesWe aimed to compare the cerebral haemodynamic response during FoG-prone locomotion tasks in patients with PD and FoG (PD-FoG), patients with PD but without FoG (PD-nFoG), and healthy controls (HCs).MethodsTwelve PD-FoG patients, 10 PD-nFoG patients, and 12 HCs were included in the study. Locomotion tasks included normal stepping, normal turning and fast turning ranked as three difficulty levels based on kinematic requirements and probability of provoking FoG. During each task, we used functional near-infrared spectroscopy to capture concentration changes of oxygenated haemoglobin (ΔHBO2) and deoxygenated haemoglobin (ΔHHB) that reflected cortical activation, and recorded task performance time. The cortical regions of interest (ROIs) were prefrontal cortex (PFC), supplementary motor area (SMA), premotor cortex (PMC), and sensorimotor cortex (SMC). Intra-cortical functional connectivity during each task was estimated based on correlation of ΔHBO2 between ROIs. Two-way multivariate ANOVA with task performance time as a covariate was conducted to investigate task and group effects on cerebral haemodynamic responses of ROIs. Z statistics of z-scored connectivity between ROIs were used to determine task and group effects on functional connectivity.ResultsPD-FoG patients spent a nearly significant longer time completing locomotion tasks than PD-nFoG patients. Compared with PD-nFoG patients, they showed weaker activation (less ΔHBO2) in the PFC and PMC. Compared with HCs, they had comparable ΔHBO2 in all ROIs but more negative ΔHHB in the SMC, whereas PD-nFoG showed SMA and PMC hyperactivity but more negative ΔHHB in the SMC. With increased task difficulty, ΔHBO2 increased in each ROI except in the PFC. Regarding functional connectivity during normal stepping, PD-FoG patients showed positive and strong PFC-PMC connectivity, in contrast to the negative PFC-PMC connectivity observed in HCs. They also had greater PFC-SMC connectivity than the other groups. However, they exhibited decreased SMA-SMC connectivity when task difficulty increased and had lower SMA-PMC connectivity than HCs during fast turning.ConclusionInsufficient compensatory cortical activation and depletion of functional connectivity during complex locomotion in PD-FoG patients could be potential mechanisms underlying FoG.Clinical trial registrationChinese clinical trial registry (URL: http://www.chictr.org.cn, registration number: ChiCTR2100042813).
Associations of mTBI and post-traumatic stress to amygdala structure and functional connectivity in military Service Members
Authors: Gimbel Sarah I. , Wang Cailynn C. , Hungerford Lars , Twamley Elizabeth W. , Ettenhofer Mark L. 
Published: March 2023

IntroductionTraumatic brain injury (TBI) is one of the highest public health priorities, especially among military personnel where comorbidity with post-traumatic stress symptoms and resulting consequences is high. Brain injury and post-traumatic stress symptoms are both characterized by dysfunctional brain networks, with the amygdala specifically implicated as a region with both structural and functional abnormalities.MethodsThis study examined the structural volumetrics and resting state functional connectivity of 68 Active Duty Service Members with or without chronic mild TBI (mTBI) and comorbid symptoms of Post-Traumatic Stress (PTS).Results and discussionStructural analysis of the amygdala revealed no significant differences in volume between mTBI and healthy comparison participants with and without post-traumatic stress symptoms. Resting state functional connectivity with bilateral amygdala revealed decreased anterior network connectivity and increased posterior network connectivity in the mTBI group compared to the healthy comparison group. Within the mTBI group, there were significant regions of correlation with amygdala that were modulated by PTS severity, including networks implicated in emotional processing and executive functioning. An examination of a priori regions of amygdala connectivity in the default mode network, task positive network, and subcortical structures showed interacting influences of TBI and PTS, only between right amygdala and right putamen. These results suggest that mTBI and PTS are associated with hypo-frontal and hyper-posterior amygdala connectivity. Additionally, comorbidity of these conditions appears to compound these neural activity patterns. PTS in mTBI may change neural resource recruitment for information processing between the amygdala and other brain regions and networks, not only during emotional processing, but also at rest.
Cognitive fitness modulates gender differences in sleep and mental health among competitive athletes under chronic stress
Authors: Mascaro Luis , Drummond Sean P. A. , Leota Josh , Boardman Johanna M. , Hoffman Daniel , Rajaratnam Shantha M. W. , Aidman Eugene , Facer-Childs Elise R. 
Published: March 2023

Objectives: Mental fitness is increasingly considered a key component of an athlete’s competitive arsenal. Active domains of mental fitness include cognitive fitness, sleep, and mental health; and these domains can differ between men and women athletes. Our study investigated the associations of cognitive fitness and gender to sleep and mental health, and the interaction between cognitive fitness and gender on sleep and mental health, in competitive athletes during the COVID-19 pandemic.Methods: 82 athletes competing at levels from regional/state to international (49% women, M-age = 23.3 years) completed measures of self-control, intolerance of uncertainty, and impulsivity (together representing constructs of cognitive fitness), items about sleep (total sleep time, sleep latency, and mid-sleep time on free days) and a measure of mental health (depression, anxiety, and stress).Results: Women athletes reported lower self-control, higher intolerance of uncertainty, and higher positive urgency impulsivity compared with men athletes. Women reported sleeping later, but this gender difference disappeared after controlling for cognitive fitness. Women athletes—after controlling for cognitive fitness—reported higher depression, anxiety, and stress. Across genders, higher self-control was associated with lower depression, and lower intolerance of uncertainty was associated with lower anxiety. Higher sensation seeking was associated with lower depression and stress, and higher premeditation was associated with greater total sleep time and anxiety. Higher perseverance was associated with higher depression for men—but not women—athletes.Conclusion: Women athletes in our sample reported poorer cognitive fitness and mental health compared to men athletes. Most cognitive fitness factors protected competitive athletes under chronic stress, but some exposed them to poorer mental health. Future work should examine the sources of gender differences. Our findings suggest a need to develop tailored interventions aimed at improving athlete wellbeing, with a particular focus on women athletes.
From experience to expectation: The reverse effect of power on purchasing impulsiveness
Authors: Wang Yanzhi , Yao Tang , Qiu Qi 
Published: March 2023

IntroductionPrevious literatures have mainly explored the impact of the experience of power on impulsive buying, but have ignored the impacts of the expectations of power. The purpose of this research is to delineates a two-facet portrait of power in the role of affecting purchase impulsiveness by proposing a theoretical extension from the experience of power to the expectations of power.MethodsFour laboratory experiments were developed that used ANOVA to verify the hypothesis. A moderated mediation path model was established including the experience of power, product attribute, the expectations of power, deservingness, and purchasing impulsiveness as observed variables.ResultsThe results revealed that powerless consumers are more likely to impulsively buy hedonic products; while powerful consumers prefer to impulsively buy utilitarian products. However, when focusing on the expectations of power, powerless consumers feel a lower perception of deservingness, which reduces their impulse to buy hedonic products. In contrast, when powerful consumers imagine how powerful people should behave in consumption, they will experience a higher sense of deservingness and increase purchasing impulsiveness for hedonic products. The underlying mechanism is that deservingness plays a mediation role in the three-way interaction impacts of the experience of power, product attribute, and the expectations of power on purchasing impulsiveness.ConclusionThe current research formulates a new theoretical perspective on the relationship between power and purchasing impulsiveness. An experience-expectation model of power is presented that proposes consumers’ purchasing impulsiveness can be affected both by the experience of power and the expectations of power.
Longitudinal progression of choroid plexus enlargement is associated with female sex, cognitive decline and ApoE E4 homozygote status
Authors: Novakova Martinkova Julie , Ferretti Maria Teresa , Ferrari Alberto , Lerch Ondrej , Matuskova Veronika , Secnik Juraj , Hort Jakub ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: March 2023

IntroductionChoroid plexus (CP)-related mechanisms have been implicated in the pathogenesis of neurodegenerative diseases, including Alzheimer’s disease. In this pilot study, we aimed to elucidate the association between longitudinal changes in CP volume, sex and cognitive impairment.MethodsWe assessed longitudinal changes in CP volume in a cohort of n = 613 subjects across n = 2,334 datapoints from ADNI 2 and ADNI-GO, belonging to cognitively unimpaired (CN), stable mild cognitive impairment (MCI), clinically diagnosed Alzheimer’s disease dementia (AD) or convertor (to either AD or MCI) subgroups. CP volume was automatically segmented and used as a response variable in linear mixed effect models with random intercept clustered by patient identity. Temporal effects of select variables were assessed by interactions and subgroup analyses.ResultsWe found an overall significant increase of CP volume in time (14.92 mm3 per year, 95% confidence interval, CI (11.05, 18.77), p &lt; 0.001). Sex-disaggregated results showed an annual rate of increase 9.48 mm3 in males [95% CI (4.08, 14.87), p &lt; 0.001], and 20.43 mm3 in females [95% CI (14.91, 25.93), p &lt; 0.001], indicating more than double the rate of increase in females, which appeared independent of other temporal variables. The only diagnostic group with a significant CP increase as compared to CN was the convertors group, with an increase of 24.88 mm3/year [95% CI (14, 35.82), p &lt; 0.001]. ApoE exhibited a significant temporal effect, with the E4 homozygote group’s CP increasing at more than triple the rate of non-carrier or heterozygote groups [40.72, 95% CI (25.97, 55.46), p &lt; 0.001 vs. 12.52, 95% CI (8.02, 17.02), p &lt; 0.001 for ApoE E4 homozygotes and E4 non-carriers, respectively], and may have modified the diagnostic group relationship.ConclusionOur results contribute to potential mechanisms for sex differences in cognitive impairment with a novel finding of twice the annual choroid plexus enlargement in females and provide putative support for CP-related mechanisms of cognitive deterioration and its relationship to ApoE E4.
Implementation of a peer support worker in a forensic psychiatric hospital in Germany—Views of patients
Authors: Walde Peggy , Hadala Julia , Peipe Verena , Völlm Birgit Angela 
Published: March 2023

IntroductionPeer Support has become common in psychiatric practice in the past decade. In this article we present findings from the implementation of peer support service into a forensic mental health hospital for offenders with substance use disorders from a patient's perspective.MethodsWe conducted focus groups and interviews with patients of the clinic to explore their experiences, acceptance and perceived effect of the peer support service. Data collection was conducted in two different points in time, three months and twelve months after the introduction of the of some peer support intervention. In the first time point two focus groups involving 10 patients and three semi-structured individual interviews were conducted. The second time point included one focus group with five patients and five semi-structured individual interviews. All focus groups and individual interviews were audio recorded and transcribed verbatim. Data analysis was conducted using thematic analysis.ResultsFive themes emerged, (1) attitudes toward the concept of peer support work and the peer support worker himself; (2) Activities and conversation topics; (3) experiences and effects; (4) Peer support in contrast to other professions; and (5) ideas and wishes for future peer support in the clinic. In general, patients agreed on the high value of peer support work.DiscussionFindings revealed a broad acceptance of the peer support intervention by most patients, but also some reservations. They saw the peer support worker as someone who is part of the professional team, and has a unique knowledge coming from personal experience. This knowledge often facilitated conversations about several topics related to patients experiences with substance use and their recovery journey.
A hidden pandemic? An umbrella review of global evidence on mental health in the time of COVID-19
Authors: Bower Marlee , Smout Scarlett , Donohoe-Bales Amarina , O’Dean Siobhan , Teesson Lily , Boyle Julia , Lim Denise , Nguyen Andre , Calear Alison L. , Batterham Philip J. , Gournay Kevin , Teesson Maree 
Published: March 2023

BackgroundThe mental health impacts of the COVID-19 pandemic remain a public health concern. High quality synthesis of extensive global literature is needed to quantify this impact and identify factors associated with adverse outcomes.MethodsWe conducted a rigorous umbrella review with meta-review and present (a) pooled prevalence of probable depression, anxiety, stress, psychological distress, and post-traumatic stress, (b) standardised mean difference in probable depression and anxiety pre-versus-during the pandemic period, and (c) comprehensive narrative synthesis of factors associated with poorer outcomes. Databases searched included Scopus, Embase, PsycINFO, and MEDLINE dated to March 2022. Eligibility criteria included systematic reviews and/or meta-analyses, published post-November 2019, reporting data in English on mental health outcomes during the COVID-19 pandemic.FindingsThree hundred and thirty-eight systematic reviews were included, 158 of which incorporated meta-analyses. Meta-review prevalence of anxiety symptoms ranged from 24.4% (95%CI: 18–31%, I2: 99.98%) for general populations to 41.1% (95%CI: 23–61%, I2: 99.65%) in vulnerable populations. Prevalence of depressive symptoms ranged from 22.9% (95%CI: 17–30%, I2: 99.99%) for general populations to 32.5% (95%CI: 17–52%, I2: 99.35) in vulnerable populations. Prevalence of stress, psychological distress and PTSD/PTSS symptoms were 39.1% (95%CI: 34–44%; I2: 99.91%), 44.2% (95%CI: 32–58%; I2: 99.95%), and 18.8% (95%CI: 15–23%; I2: 99.87%), respectively. Meta-review comparing pre-COVID-19 to during COVID-19 prevalence of probable depression and probable anxiety revealed standard mean differences of 0.20 (95%CI = 0.07–0.33) and 0.29 (95%CI = 0.12–0.45), respectively.ConclusionThis is the first meta-review to synthesise the longitudinal mental health impacts of the pandemic. Findings show that probable depression and anxiety were significantly higher than pre-COVID-19, and provide some evidence that that adolescents, pregnant and postpartum people, and those hospitalised with COVID-19 experienced heightened adverse mental health. Policymakers can modify future pandemic responses accordingly to mitigate the impact of such measures on public mental health.
Supply-demand balance and spatial distribution optimization of primary care facilities in highland cities from a resilience perspective: A study of Lhasa, China
Authors: Yu Yang , Zhou Rui , Qian Liyuan , Yang Xian , Dong Liuyang , Zhang Guangyuan 
Published: March 2023

IntroductionThe development of urban resilience, which is fundamentally a balance between the supply capacity of primary care resources and the demand from urban residents, includes an appropriate architecture of primary care facilities. Resilient city construction in highland areas is hampered by the physical environment and transportation constraints and frequently encounters issues like poor accessibility and unequal distribution of primary care facilities.MethodsTo optimize the supply and demand of primary care resources in highland cities and effectively improve the resilience of urban public health, this paper assesses the distribution of primary care facilities within the built-up area of Lhasa (China) through a spatial network analysis method based on GIS, combined with population distribution data, and employs a location-allocation model to optimize the distribution.ResultsFirstly, the overall supply of primary care exceeds the overall demand, but the facilities' service area can only accommodate 59% of the residences. Secondly, there is a clear spatial variation in the accessibility of primary care facilities, and the time cost of healthcare is too high in some residences. Thirdly, the supply-demand relationship of primary care facilities is unbalanced, with both over-saturated and over-deficient areas.DiscussionAfter distribution optimization, the coverage and accessibility of primary care facilities have increased significantly, and the spatial imbalance of supply and demand has been alleviated. This paper proposes a research method to evaluate and optimize the spatial distribution of primary care facilities from multiple perspectives based on the resilience theory. The results of the study and visualization analysis methods can be used as an invaluable reference for planning the distribution of urban healthcare facilities and urban resilience construction in highland areas and other underdeveloped areas.
Effectiveness of horticultural therapy in aged people with depression: A systematic review and meta-analysis
Authors: Xu Meijing , Lu Shan , Liu Jianjiao , Xu Feng 
Published: March 2023

BackgroundDepression, an increasing global crisis, has affected many people's daily life, especially for older adults. Horticultural therapy has been widely used in non-pharmacological treatment for patients with depression, with a body of studies demonstrating its therapeutic effects. However, a lack of systematic reviews and meta-analyses makes it difficult to get a holistic picture of this research field.ObjectivesWe aimed to evaluate the reliability of the previous studies and the effectiveness of horticultural therapy (including the intervention of environmental settings, activities, and duration) on older adults with depression.MethodsThis systematic review was conducted under the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines. We searched relevant studies in multiple databases, and the original search was finished on 25 September 2022. We included studies using randomized controlled trials (RCTs) or quasi-experimental designs.ResultsWe yielded a total of 7,366 studies and finally included 13 which involved 698 aged people with depression. Results from meta-analysis indicated significant effects of horticultural therapy on reducing depressive symptoms for the older adults. Besides, we found different outcomes among various horticultural interventions (such as environmental setting, activities, and duration). Depression reduction was more effective in care-providing settings than in community settings; participatory activities were more effective in reducing depression than observational activities; intervention of 4–8 weeks might represent the optimal course of treatment compared to interventions more than 8 weeks in duration.ConclusionWe came up with a comprehensive set of recommendations based on the meta-analysis: aged people in care-providing settings with depression could get the most benefit from horticultural therapy by participating in participatory activities for 4–8 weeks.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022363134, identifier CRD42022363134.