bluuebunny/crossref_metadata_2025_split huggingface dataset:
GP-delivered medication review of polypharmacy, deprescribing, and patient priorities in older people with multimorbidity in Irish primary care (SPPiRE Study): A cluster randomised controlled trial
Authors: McCarthy Caroline , Clyne Barbara , Boland Fiona , Moriarty Frank , Flood Michelle , Wallace Emma , Smith Susan M. ,   for the SPPiRE Study team
Published: January 2022

BackgroundThere is a rising prevalence of multimorbidity, particularly in older patients, and a need for evidence-based medicines management interventions for this population. The Supporting Prescribing in Older Adults with Multimorbidity in Irish Primary Care (SPPiRE) trial aimed to investigate the effect of a general practitioner (GP)-delivered, individualised medication review in reducing polypharmacy and potentially inappropriate prescriptions (PIPs) in community-dwelling older patients with multimorbidity in primary care.Methods and findingsWe conducted a cluster randomised controlled trial (RCT) set in 51 GP practices throughout the Republic of Ireland. A total of 404 patients, aged ≥65 years with complex multimorbidity, defined as being prescribed ≥15 regular medicines, were recruited from April 2017 and followed up until October 2020. Furthermore, 26 intervention GP practices received access to the SPPiRE website where they completed an educational module and used a template for an individualised patient medication review that identified PIP, opportunities for deprescribing, and patient priorities for care. A total of 25 control GP practices delivered usual care. An independent blinded pharmacist assessed primary outcome measures that were the number of medicines and the proportion of patients with any PIP (from a predefined list of 34 indicators based predominantly on the STOPP/START version 2 criteria). We performed an intention-to-treat analysis using multilevel modelling. Recruited participants had substantial disease and treatment burden at baseline with a mean of 17.37 (standard deviation [SD] 3.50) medicines. At 6-month follow-up, both intervention and control groups had reductions in the numbers of medicines with a small but significantly greater reduction in the intervention group (incidence rate ratio [IRR] 0.95, 95% confidence interval [CI]: 0.899 to 0.999,p= 0.045). There was no significant effect on the odds of having at least 1 PIP in the intervention versus control group (odds ratio [OR] 0.39, 95% CI: 0.140 to 1.064,p= 0.066). Adverse events recorded included mortality, emergency department (ED) presentations, and adverse drug withdrawal events (ADWEs), and there was no evidence of harm. Less than 2% of drug withdrawals in the intervention group led to a reported ADWE. Due to the inability to electronically extract data, primary outcomes were measured at just 2 time points, and this is the main limitation of this work.ConclusionsThe SPPiRE intervention resulted in a small but significant reduction in the number of medicines but no evidence of a clear effect on PIP. This reduction in significant polypharmacy may have more of an impact at a population rather than individual patient level.Trial registrationISRCTN RegistryISRCTN12752680.
Plant-based diets and incident cardiovascular disease and all-cause mortality in African Americans: A cohort study
Authors: Weston Leah J. , Kim Hyunju , Talegawkar Sameera A. , Tucker Katherine L. , Correa Adolfo , Rebholz Casey M. 
Published: January 2022

BackgroundPrior studies have documented lower cardiovascular disease (CVD) risk among people with a higher adherence to a plant-based dietary pattern. Non-Hispanic black Americans are an understudied group with high burden of CVD, yet studies of plant-based diets have been limited in this population.Methods and findingsWe conducted an analysis of prospectively collected data from a community-based cohort of African American adults (n= 3,635) in the Jackson Heart Study (JHS) aged 21–95 years, living in the Jackson, Mississippi, metropolitan area, US, who were followed from 2000 to 2018. Using self-reported dietary data, we assigned scores to participants’ adherence to 3 plant-based dietary patterns: an overall plant-based diet index (PDI), a healthy PDI (hPDI), and an unhealthy PDI (uPDI). Cox proportional hazards models were used to estimate associations between plant-based diet scores and CVD incidence and all-cause mortality. Over a median follow-up of 13 and 15 years, there were 293 incident CVD cases and 597 deaths, respectively. After adjusting for sociodemographic characteristics (age, sex, and education) and health behaviors (smoking, alcohol intake, margarine intake, physical activity, and total energy intake), no significant association was observed between plant-based diets and incident CVD for overall PDI (hazard ratio [HR] 1.06, 95% CI 0.78–1.42,p-trend = 0.72), hPDI (HR 1.07, 95% CI 0.80–1.42,p-trend = 0.67), and uPDI (HR 0.95, 95% CI 0.71–1.28,p-trend = 0.76). Corresponding HRs (95% CIs) for all-cause mortality risk with overall PDI, hPDI, and uPDI were 0.96 (0.78–1.18), 0.94 (0.76–1.16), and 1.06 (0.86–1.30), respectively. Corresponding HRs (95% CIs) for incident coronary heart disease with overall PDI, hPDI, and uPDI were 1.09 (0.74–1.61), 1.11 (0.76–1.61), and 0.79 (0.52–1.18), respectively. For incident total stroke, HRs (95% CIs) for overall PDI, hPDI, and uPDI were 1.00 (0.66–1.52), 0.91 (0.61–1.36), and 1.26 (0.84–1.89) (p-trend for all tests > 0.05). Limitations of the study include use of self-reported dietary intake, residual confounding, potential for reverse causation, and that the study did not capture those who exclusively consume plant-derived foods.ConclusionsIn this study of black Americans, we observed that, unlike in prior studies, greater adherence to a plant-based diet was not associated with CVD or all-cause mortality.
Prevalence and determinants of using complementary and alternative medicine for the treatment of chronic illnesses: A multicenter study in Bangladesh
Authors: Shahjalal Md. , Chakma Samar Kishor , Ahmed Tanvir , Yasmin Irin , Mahumud Rashidul Alam , Hossain Ahmed 
Published: January 2022

Background
While conventional medicine (CM) is commonly used to treat non-communicable diseases (NCDs), complementary and alternative medicine (CAM) is gaining popularity as a healthcare option in Bangladesh. We aimed to investigate the prevalence and factors associated with using CAM solely and using CAM in conjunction with CM for chronic illness treatment among NCD patients in Bangladesh.

Methods
A multicenter cross-sectional study was conducted, including 549 adults with a confirmed chronic illness diagnosis from three tertiary care hospitals in Dhaka city. Interviews were used to gather socio-demographic data, while medical records were used to get information on chronic illnesses. A multinomial logistic regression model was used to determine the associated factors of utilizing CAM primarily and CAM use in conjunction with CM to manage the chronic disease.

Results
Out of 549 NCD patients (282 women [51.4%], mean [standard deviation] age 45.4 [12.8] years), 180 (32.8%) ever used CAM for the treatment of chronic illness. Also, 15.3% of patients exclusively used CAM among the NCD patients, while 17.5% used CAM in conjunction with CM. Homeopathy medicine was the most prevalent type of treatment among CAM users (52.2%). Furthermore, 55.5% of CAM users said they used it due to its less adverse effects, and 41.6% trusted its effectiveness for chronic illness. Elderly patients (≥60 years) preferred CAM in complementary with CM, but they did not rely only on CAM. According to the multinomial regression analysis, unmarried patients, predominantly in the younger age group, adopted CAM significantly for chronic illness treatment (Relative risk ratio, RRR = 0.29, 95% CI = 0.12–0.71, reference = Unmarried). Patients in the high-income group used CAM in conjunction with CM (RRR = 6.26, 95% CI = 1.35–18.90, reference: low-income), whereas patients in the high-income group did not rely on CAM alone (RRR = 0.99, 95% CI = 0.34–2.85).

Conclusion
Although CM remains the mainstream of health care in Bangladesh, CAM services play an essential role in people’s health care, particularly in treating chronic illnesses. Physicians of Bangladesh should be aware that their patients may be using other services and be prepared to ask and answer questions regarding the risks and benefits of using CAM in addition to regular medical care. Thus, clinicians required to follow best-practice guidelines, which are currently not practiced in Bangladesh, when disseminating information regarding integrative techniques that combine CM and CAM approaches.
Effect of the subjective intensity of fatigue and interoception on perceptual regulation and performance during sustained physical activity
Authors: Greenhouse-Tucknott Aaron , Butterworth Jake B. , Wrightson James G. , Harrison Neil A. , Dekerle Jeanne 
Published: January 2022

BackgroundThe subjective experience of fatigue impairs an individual’s ability to sustain physical endurance performance. However, precise understanding of the specific role perceived fatigue plays in the central regulation of performance remains unclear. Here, we examined whether the subjective intensity of a perceived state of fatigue, pre-induced through prior upper body activity, differentially impacted performance and altered perceived effort and affect experienced during a sustained, isometric contraction in lower body. We also explored whether (cardiac) interoception predicted the intensity of experienced perceptual and affective responses and moderated the relationships between constructs during physical activity.MethodsUsing a repeated-measures study design, thirty male participants completed three experimental conditions, with the intensity of a pre-induced state of fatigue manipulated to evoke moderate (MOD), severe (SEV) and minimal (control; CON) intensity of perceptions prior to performance of the sustained contraction.ResultsPerformance of the sustained contraction was significantly impaired under a perceived state of fatigue, with reductions of 10% and 14% observed in the MOD and SEV conditions, respectively. Performance impairment was accompanied by greater perceived effort and more negative affective valence reported during the contraction. However, effects were limited to comparisons to CON, with no difference evident between the two experimental trials (i.e. MODvs. SEV). Individuals’ awareness of their accuracy in judging resting heartbeats was shown to predict the subjective intensity of fatigue experienced during the endurance task. However, interoception did not moderate the relationships evident between fatigue and both perceived effort and affective valence.ConclusionsA perceived state of fatigue limits endurance performance, influencing both how effortful activity is perceived to be and the affective experience of activity. Though awareness of interoceptive representations of bodily states may be important to the subjective experience of fatigue, interoception does not modulate the relationships between perceived fatigue and other perceptual (i.e. effort) and affective constructs.
The Spatial Model of Paddy Productivity Based on Environmental Vulnerability in Each Phase of Paddy Planting
Authors: Susanti Rahmatia , Supriatna S. , Rokhmatulah R. , Manessa Masita Dwi Mandini , Poniman Aris , Ramadhani Yoniar Hufan 
Published: January 2022

The national primary always growth and increase in line with the increase in population, such as the rise of rice consumption in Indonesia. Paddy productivity influenced by the physical condition of the land and the declining of those factors can detected from the environmental vulnerability parameters. Purpose of this study was to compile a spatial model of paddy productivity based on environmental vulnerability in each planting phase using the remote sensing and GIS technology approaches. This spatial model is compiled based on the results of the application of two models, namely spatial model of paddy planting phase and paddy productivity. The spatial model of paddy planting phase obtained from the analysis of vegetation index from Sentinel-2A imagery using the random forest classification model. The variables for building the spatial model of the paddy planting phase are a combination of NDVI vegetation index, EVI, SAVI, NDWI, and time variables. The overall accuracy of the paddy planting phase model is 0.92 which divides the paddy planting phase into the initial phase of planting, vegetative phase, generative phase, and fallow phase. The paddy productivity model obtained from environmental vulnerability analysis with GIS using the linear regression method. The variables used are environmental vulnerability variables which consist of hazards from floods, droughts, landslides, and rainfall. Estimation of paddy productivity based on the influence of environmental vulnerability has the best accuracy done at the vegetative phase of 0.63 and the generative phase of 0.61 while in the initial phase of planting cannot be used because it has a weak relationship with an accuracy of 0.35.
The crystal structure of 2,2′-((1E,1′E)-hydrazine-1,2-diylidenebis(methaneylylidene))bis(4-chlorophenol), C14H10Cl2N2O2
Authors: Fan Xu , Liu Ke-Xiang , Zhu Hong-Yu , Li Zhong-Yan , Yuan Lin 
Published: January 2022

Abstract
C14H10Cl2N2O2, triclinic,

P

1
‾

$P\overline{1}$

(no. 2), a = 6.165(12) Å, b = 7.192(13) Å, c = 7.829(15) Å, α = 74.97(2)°, β = 81.92(2)°, γ = 79.84(2)°, V = 328.3(11) Å3, Z = 1, R

gt
(F) = 0.0312, wR

ref
(F
2) = 0.0859, T = 296(2) K.
An overview of in silico methods used in the design of VEGFR-2 inhibitors as anticancer agents
Authors: Bhandare Richie R. , Bakchi Bulti , Sigalapalli Dilep Kumar , Shaik Afzal B. 
Published: January 2022

Abstract
VEGFR-2 enzyme known for physiological functioning of the cell also involves in pathological angiogenesis and tumor progression. Recently VEGFR-2 has gained the interest of researchers all around the world as a promising target for the drug design and discovery of new anticancer agents. VEGFR2 inhibitors are a major class of anticancer agents used for clinical purposes. In silico methods like virtual screening, molecular docking, molecular dynamics, pharmacophore modeling, and other computational approaches help extensively in identifying the main molecular interactions necessary for the binding of the small molecules with the respective protein target to obtain the expected pharmacological potency. In this chapter, we discussed some representative case studies of in silico techniques used to determine molecular interactions and rational drug design of VEGFR-2 inhibitors as anticancer agents.
Recent developments in the synthesis and anti-cancer activity of acridine and xanthine-based molecules
Authors: Majhi Sasadhar 
Published: January 2022

Abstract
Cancer is the uncontrolled growth and development of abnormal cells which is a major cause of death in both advanced and emerging countries. Although currently chemotherapy is most broadly used among an extensive range of anti-cancer therapies, it includes many demerits, such as highly toxic, side-effects, expensive and partial lack of targeting specificity. So the design and synthesis of new molecules that perform specifically on target proteins in tumor cells is a focus of contemporary research. So many researchers aim for new drugs that will be more efficient, more selective, and less toxic. Because of the interesting structures and significant biological profile, naturally occurring acridines and xanthines as well as their analogues have attracted considerable interest in researchers and technologists. Natural and synthetic acridine derivatives form a significant category of heterocycles having nitrogen that is of considerable interest for organic chemists and biological communities due to their attractive anti-cancer activity. Another important class of therapeutic agents with diverse biological properties including cytotoxic effects is xanthine derivatives which are collectively called xanthines (a group of alkaloids). Among many significant molecules based on the structure of the purine, there is a group of natural xanthines, involving theobromine, caffeine, and theophylline and analogues of xanthine display anti-cancer activity. Hence the present chapter wishes to concentrate the attention on the synthesis and anti-cancer activity of acridine and xanthine-based compounds brilliantly.
Investigation on the Shear Behavior of Rough Rock Joints Prepared by Three-Dimensional Engraving Technique
Authors: Zhang Xiaobo , Zhu Xi , Yao Chi , Ouyang Shu , Yang Jianhua , Jiang Qinghui 
Published: January 2022

Abstract
Laboratory shear test is an important and widely used method to investigate the shear behavior of rock joints, and the preparation of joint specimens is a key factor that influences test results. In order to study the shear mechanism of rough rock joints with different morphologies in the laboratory, an innovative three-dimensional (3D) engraving technique was employed to produce specimens with rough joints. Intact sandstone and cement mortar blocks were used as model materials. The engraving parameters were determined to ensure a satisfactory engraving precision and to save as much time as possible for an engraving process. Three Barton profiles with joint roughness coefficient (JRC) values of 2.8, 10.8, and 18.7 were selected as the morphology prototypes for automatically engraving the model material blocks to obtain rough joint specimens. Shear tests were then conducted under four normal stress levels in the laboratory. In addition, numerical simulations on joints with the same physico-mechanical properties, surface morphology, and boundary conditions as the joint tested in the laboratory were performed. The failure characteristics, shear behavior curves, and shear strength obtained from numerical and experimental studies were analyzed considering the effect of joint materials, joint roughness, and applied normal stress. The shear mechanism of rough joints was investigated, and the analysis indicated that the results of shear tests by simulation and experiment were similar. The results revealed that it is feasible to make rough joints by engraving either real rocks or commonly used model materials (e.g., cement mortar).
UNIT AND UNITARY CAYLEY GRAPHS FOR THE RING OF EISENSTEIN INTEGERS MODULO \(n\)
Authors: Jahani-Nezhad Reza , Bahrami Ali 
Published: January 2022

Let \({E}_{n}\) be the ring of Eisenstein integers modulo \(n\). We denote by \(G({E}_{n})\) and \(G_{{E}_{n}}\), the unit graph and the unitary Cayley graph of \({E}_{n}\), respectively. In this paper, we obtain the value of the diameter, the girth, the clique number and the chromatic number of these graphs. We also prove that for each \(n>1\), the graphs \(G(E_{n})\) and \(G_{E_{n}}\) are Hamiltonian.
How much does the Level of Physical Activity Change in Patients with Physical Disabilities Hospitalized for Rehabilitation?
Authors: CANKURTARAN Damla , GÜZEL Şükran , UNLU AKYUZ Ece , UMAY Ebru 
Published: January 2022

Objective: This study aimed to examine the short term effect of inpatient rehabilitation program on self –reported physical activity in participants with physical disabilities.
Material and Methods: The patients were divided into groups as group 1: individuals with physical disability due to musculoskeletal diseases, and group 2: individuals with physical disability due to neurological diseases. The results of Physical Activity Scales for Individuals with Physical Disabilities (PASIPD) at one month after discharge (PA2) compared with the results of PASIPD at hospitalization (PA1). The first assessment was done face-to face, but the assessment after discharge were made using phone.
Results: There was a significant difference between PA2 and PA1 in group 1, group 2, and among all participants (p=0.001). The change in physical activity level from hospitalization to one month after discharge was similar in the two groups (p=0.564).
Conclusion: While people learn to live with a disability, quickly integrating physical activity with rehabilitation program into their new daily routine can be seen as a good strategy.
Percepção das pessoas Trans acerca do acesso ao mercado de trabalho
Authors: Fonseca Ferreira Fabrício , Sousa Ribeiro Thaís Monielly , Ferreira de Brito Worney 
Published: January 2022

INTRODUÇÃO: A transexualidade define-se como a não identificação com o gênero socialmente atribuído no nascimento. Diante do exposto, travestis e transexuais são pessoas que ultrapassam as fronteiras do gênero e produzem uma desestruturação binária e polarizada de gênero que contesta o modo de vida heterossexual e cisgênero, assim refletindo diretamente em vários aspectos de suas vidas, principalmente no que tange ao acesso ao mercado de trabalho formal. OBJETIVO: Explorar a percepção de pessoas transexuais acerca das dificuldades de acesso ao mercado de trabalho formal. MATERIAIS E MÉTODOS: A pesquisa foi realizada com pessoas transgênero, das cidades do norte de Minas Gerais (MG) e que tenham tido experiência no mercado de trabalho. O material empírico foi produzido a partir de entrevistas com as/os participantes através do critério de saturação e aplicação do questionário WHOQOL-Bref, tendo os dados sido interpretados com base na análise do discurso de Pêcheux. RESULTADOS E DISCUSSÃO: Observou-se que a percepção das pessoas trans acerca do acesso ao mercado de trabalho é fortemente influenciada pelos papéis de gênero com que se identificam, atrelada a uma dificuldade de acesso ao ensino, com reflexos na qualidade de vida dessas pessoas, oriundos de atitudes de preconceito. CONSIDERAÇÕES FINAIS: A transgeneridade é um tema importante que abarca as questões de gênero e de sexualidade. O desenvolvimento de pesquisas científicas voltadas para a população LGBTQIA+ se faz mais que necessário, uma vez que a sociedade cis e heteronormativa sistematicamente precariza e invisibiliza essas vivências.
Practice report: an Alberta Métis model for COVID-19 vaccine delivery
Authors: King Keith D. , Bartel Reagan , James Ashton , MacDonald Shannon E. 
Published: January 2022

AbstractSettingIn January 2021, the COVID-19 vaccine became available to First Nations, Métis, and Inuit (FNMI) over the age of 65 living in First Nations communities or Métis settlements in Alberta. In March, vaccine eligibility in Alberta expanded to include FNMI peoples of younger ages and in urban settings. The Métis Nation of Alberta (MNA) and other Indigenous organizations recognized that FNMI populations might be better served by tailored vaccine programs.InterventionThe MNA is the government for the Métis people in Alberta. During the COVID-19 pandemic, the MNA has supported its citizens, through financial and mental wellness support, access to personal protective equipment, and messaging regarding public health orders. When vaccines became available, culturally appropriate virtual vaccine information sessions were provided. In March 2021, the MNA delivered the first Métis-led COVID-19 vaccination clinic. Unique to the clinic’s success was the location, online booking process, and community presence. The clinic focused on cultural safety, including the availability of Indigenous health professionals to community members, and cultural reference points throughout the clinic.OutcomesIn the first MNA clinic, over 1300 people were vaccinated. Visitors shared appreciation for the culturally specific aspects of the clinic, which contributed to increased safety and comfort.ImplicationsBased on the success of the first Métis-led vaccination clinic, similar services in communities with high numbers of Métis people have been approved. This innovative practice initiative could provide a model of COVID-19 vaccine service delivery that could be used to meet the needs of Métis citizens in other jurisdictions in Canada.