bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microbiological screening tests for SARS-CoV-2 in the first hour since the hospital admission: A reliable tool for enhancing the safety of pediatric care
Authors: Vetrugno Giuseppe , Grassi Simone , Clemente Francesco , Cazzato Francesca , Rossi Vittoria , Grassi Vincenzo M. , Buonsenso Danilo , Filograna Laura , Sanguinetti Maurizio , Focardi Martina , Valentini Piero , Ozonoff Al , Pinchi Vilma , Oliva Antonio 
Published: September 2022

Introduction/purposeSince a significant proportion of SARS-CoV-2 infections occur within healthcare facilities, a multidisciplinary approach is required for careful and timely assessment of the risk of infection in asymptomatic patients or those whose COVID-19 diagnosis has not yet been made. The aim of this study was to investigate whether an adaptative model based on microbiological testing can represent a valid risk management strategy.Material and methodsWe collected data from the risk management unit database of a 1,550-bed tertiary hospital (Fondazione Policlinico Gemelli IRCCS, Rome, Italy) concerning pediatric admissions to the Emergency Department (ED) from 1 March 2020 to 31 December 2021. The study period was subdivided in period A and period B according to the technique used for the microbiological screening, respectively reverse-transcription polymerase chain reaction (RT-PCR) and antigen-detection test.ResultsIn Period A, 426 children (mean age: 6 years) underwent microbiological screening at the ED. The total number of molecular tests performed was 463. 459/463 tested negative at the molecular test. In Period B, 887 children (mean age: 6 years) underwent microbiological screening in the ED. The total number of molecular tests performed was 1,154. 1,117/1,154 tested negative at the molecular test. Neither in Period A nor in Period B hospital-acquired SARS-CoV-2 infections were reported.Discussion and conclusionDespite high volumes, no cases of hospital-acquired SARS-CoV-2 infection have been reported. SARS-CoV-2 antigen-based tests can be used as a first-line option as they provide rapid results compared to RT-PCR, reducing the risk of infection in ED waiting rooms.
Co-prescribing of opioids and benzodiazepines/Z-drugs associated with all-cause mortality—A population-based longitudinal study in primary care with weak opioids most commonly prescribed
Authors: Linnet Kristjan , Thorsteinsdottir Heidrun Sjofn , Sigurdsson Johann Agust , Sigurdsson Emil Larus , Gudmundsson Larus Steinthor 
Published: September 2022

Introduction: The risk of mortality associated with the co-prescribing of benzodiazepines and opioids has been explored in a number of papers mainly focusing on strong opioids. The mortality risk associated with the use of weak opioids has not been dealt with to a similar extent.Objective: To assess the mortality risk in primary care patients with consistent 3-year co-prescribing of benzodiazepine/Z-drugs (benzodiazepine receptor modulators) and mainly weak opioids (codeine, tramadol).Methods: Of 221,804 patients contacting the primary healthcare centres, 124,436 were selected for further analysis, 88,832 participants fulfilled the inclusion criteria, aged 10–69 years and were divided into four groups with neither any use of benzodiazepines/Z-drugs nor opioids as Group 1, 3 years’ use of opioids and no/minimal benzodiazepines/Z-drugs as Group 2, with benzodiazepines/Z-drugs and no/minimal opioids as Group 3, and finally both benzodiazepines/Z-drugs and opioids as Group 4. Hazard ratios were calculated with the no-drug group as a reference, using Cox proportional hazards regression model adjusted for age, sex, number of chronic conditions and cancer patients excluded (n = 87,314).Results: Hazard ratios for mortality increased both in Group 3 where it was 2.66 (95% CI 2.25–3.09) and in Group 4 where it was 5.12 (95% CI 4.25–6.17), with increased dose and higher number of chronic conditions. In Group 4 an opioid dose-dependent increase in mortality among persons using &gt;1000 DDDs benzodiazepines/Z-drugs was observed when those on less than ≤300 DDDs of opioids with HR 4.94 (95% CI 3.54–6.88) were compared to those on &gt;300 DDDs with HR 7.61/95% CI 6.08–9.55). This increase in mortality was not observed among patients on &lt;1000 DDDs of benzodiazepines/Z-drugs.Conclusion: The study supports evidence suggesting that mortality increases in a dose-dependent manner in patients co-prescribed benzodiazepines/Z-drugs and weak opioids (codeine, tramadol). An association between the number of chronic conditions and a rise in mortality was found. Long-term use of these drugs should preferably be avoided. Non-pharmacological therapy should be seriously considered instead of long-term use of benzodiazepines/Z-drugs, and deprescribing implemented for chronic users of these drugs when possible.
The effects of oral and vaporized cannabis alone, and in combination with alcohol, on driving performance using the STISIM driving simulator: A two-part, double-blind, double-dummy, placebo-controlled, randomized crossover clinical laboratory protocol
Authors: Zamarripa C. Austin , Novak Matthew D. , Weerts Elise M. , Vandrey Ryan , Spindle Tory R. 
Published: September 2022

The legalization of cannabis for medicinal and non-medicinal purposes, and the corresponding increase in diversity of cannabis products, has resulted an urgent need for cannabis regulatory science. Among the most pressing needs is research related to impairment due to cannabis exposure, especially on driving performance. The present project was designed to evaluate the impact of oral and vaporized cannabis, when administered alone or in combination with alcohol, on simulated driving performance (STISIM driving simulator), cognitive/psychomotor ability, and field sobriety performance. Healthy adults will complete two, double-blind, double-dummy, placebo-controlled, randomized crossover clinical laboratory studies, one with oral cannabis (16 men/16 women) and the second with vaporized cannabis (16 men/16 women). In each study, participants will complete seven experimental sessions during which acute doses of placebo or high Δ9-THC cannabis containing 0, 10, or 25 mg Δ9-THC will be administered both alone and in combination with placebo or alcohol-containing beverages (target breath alcohol concentrations, BAC, of 0.0% or 0.05%). A positive control session (i.e., alcohol at target BAC of 0.08% with placebo cannabis) will also be completed. Simulated driving performance tests (available for download; see Methods), field sobriety assessments, subjective drug effect questionnaires, a mobile device impairment test (DRUID app), and collection of whole blood specimens will be completed repeatedly during each session. Linear mixed models will be used to test for differences across experimental conditions and a priori planned comparisons will be used to determine differences between conditions of interest (e.g., cannabis alone vs cannabis with alcohol). This research is designed to extend prior studies of cannabis and alcohol on driving performance by using oral and vaporized routes of cannabis administration. By increasing understanding of impairment associated with co-use of alcohol and these novel forms of cannabis, this research could inform impairment detection standards for cannabis and alcohol and have important implications for law enforcement, public policy decisions regarding accessibility of these substances, and education of the general population who may use cannabis and/or alcohol. Lastly, this manuscript provides interested researchers with access to the simulated driving scenarios and data extraction tools developed for this study as a means of facilitating future cross-study comparisons, which is important given the heterogeneity in methods used across laboratories in prior research.
Online survey of medicinal cannabis users: Qualitative analysis of patient-level data
Authors: Garcia-Romeu Albert , Elmore Joshua , Mayhugh Rhiannon E. , Schlienz Nicolas J. , Martin Erin L. , Strickland Justin C. , Bonn-Miller Marcel , Jackson Heather , Vandrey Ryan 
Published: September 2022

Aim: To characterize perceived benefits and challenges experienced by medicinal cannabis users.Methods: An anonymous online survey collected demographics, health information, and open-ended responses from medicinal cannabis users regarding perceptions, motivations, and experience of treatment. Qualitative open-ended responses were thematically analyzed.Results: Respondents (N = 808) were predominantly White (79%), female (63%), with a mean (SD) age of 38 (20). Two hundred eighty-four (35%) respondents provided data on a dependent family member (e.g., child; 22% of total sample). Most used cannabidiol (CBD)-dominant products (58%), primarily for neurological disorders (38%) or pain (25%). Primary motivations for medicinal cannabis use were based on beliefs that traditional treatments were ineffective and/or had intolerable side effects (51%), positive scientific or media portrayals of the safety/efficacy of cannabis as a therapeutic (29%), or preference for “natural” treatments over pharmaceuticals (21%). A majority of respondents (77%) attributed positive effects to the medicinal use of cannabis/cannabinoids. These included physical symptom improvements such as reduced pain (28%), improved sleep (18%), and seizure reduction (18%), and mental health improvements including reduced anxiety (22%) and improved mood (11%). Additionally, respondents reported reduced use of other medications (e.g., opioids) (12%), and improved quality of life (14%). Problems associated with use were cited by 41% of respondents, and included unwanted side effects (16%), lack of information or medical support (16%), prohibitive costs (12%), and legal concerns (10%).Conclusion: Most participants reported benefits from cannabis use for a variety of conditions where traditional treatments were ineffective or unacceptable. Concerns regarding cannabis side effects, legality, lack of information, and cost were raised. Data indicate greater research and education on the safety and efficacy of medicinal cannabis/cannabinoid use is warranted.
Comparative effectiveness of individualized longer and standardized shorter regimens in the treatment of multidrug resistant tuberculosis in a high burden country
Authors: Wahid Abdul , Ghafoor Abdul , Khan Abdul Wali , Al-Worafi Yaser Mohammed , Latif Abdullah , Shahwani Nisar Ahmed , Atif Muhammad , Saleem Fahad , Ahmad Nafees 
Published: September 2022

Objective: To compare the effectiveness of second line injectables containing shorter (duration 9–12 months) and longer treatment regimens (LTR, duration ≥ 20 months) among multidrug-resistant tuberculosis (MDR-TB) patients with no documented resistance and history of treatment with any second-line anti-TB drug (SLD) for ≥ 1 month.Methods: This was an observational cohort study of MDR-TB patients treated at eight PMDT units in Pakistan. Patients’ data from baseline until treatment outcomes were collected from Electronic Nominal Recording and Reporting System. The treatment outcomes of “cured” and “treatment completed” were grouped together as successful, whereas “death,” “treatment failure,” and “lost to follow-up” were collectively grouped as unsuccessful outcomes. Time to sputum culture conversion (SCC) was analyzed using the Kaplan–Meier method and the differences between groups were compared through the log-rank test. Multivariate Cox proportional hazards and binary logistic regression analyses were used to find predictors of time to SCC and unsuccessful treatment outcomes. A p-value &lt; 0.05 was considered statistically significant.Results: A total 701 eligible MDR-TB patients [313 treated with shorter treatment regimen (STR) and 388 treated with LTR at eight centres in Pakistan were evaluated]. Time to achieve SCC was significantly shorter in STR group [mean: 2.03 months, 95% confidence interval (CI):1.79–2.26] than in LTR group (mean: 2.69 months, 95% CI: 2.35–3.03) (p-value&lt;0.001, Log-rank test). Treatment success was higher in STR (83.7%) than in LTR (73.2%) group (p-value &lt;0.001) due to high cure (79.9% vs. 70.9%, p-value = 0.006) and low death (9.9% vs. 18.3%, p-value = 0.002) rates with STR. Treatment with STR emerged the only predictor of early SCC [adjusted Hazards ratio (aHR) = 0.815, p-value = 0.014], whereas, patient’s age of 41–60 (OR = 2.62, p-value&lt;0.001) and &gt;60 years (OR = 5.84, p-value&lt;0.001), baseline body weight of 31–60 (OR = 0.36, p-value = 0.001) and &gt;60 kg (OR = 0.23, p-value &lt;0.001), and treatment with LTR (OR = 1.88, p-value = 0.001) had statistically significant association with unsuccessful treatment outcomes.Conclusion: STR exhibited superior anti-microbial activity against MDR-TB. When compared LTR, treatment with STR resulted in significantly early SCC, high cure, and lower death rates among MDR-TB patients who had no documented resistance and history of treatment with any SLD ≥ 1 month.
Short-term efficacy of music therapy combined with α binaural beat therapy in disorders of consciousness
Authors: Liu Zi-Bo , Liu Yan-Song , Zhao Long , Li Man-Yu , Liu Chun-Hui , Zhang Chun-Xia , Li Hong-Ling 
Published: September 2022

ObjectiveTo investigate the short-term effect of music therapy combined with binaural frequency difference therapy on patients with consciousness disorder.Materials and methodsNinety patients with definite diagnosis of disorders of consciousness (DOC) were selected. These patients were randomly divided into control group, experiment 1 group and experiment 2 group, with 30 patients in each group. The control group was treated with routine clinical treatment and rehabilitation. In experiment 1 group, music therapy was added to the control group. In experimental group 2, music therapy combined with binaural α frequency difference therapy was added to the control group. All patients were assessed before and after 30 treatments. The assessment items included Glasgow Coma Scale (GCS), Coma Recovery Scale revised (CRS-R), electroencephalogram (EEG), upper somatosensory evoked potential (USEP), and brainstem auditory evoked potential (BAEP).ResultsBefore treatment, there were no significant differences in GCS score, CRS-R score, USEP, BAEP, and EEG scores among the three groups (P &gt; 0.05). After 30 times of treatment, GCS score, CRS-R score, USEP, BAEP, and EEG scores in 3 groups were significantly higher than those before treatment (P &lt; 0.05), and experimental group 2 &gt;experimental group 1 &gt;control group (P &lt; 0.05). And the consciousness rate of experimental group 2 was better than experimental group 1, experimental group 1 was better than the control group and the difference was statistically significant (P &lt; 0.05).ConclusionMusic therapy combined with binaural α frequency difference therapy is more effective in stimulating DOC patients.
Authentic leadership and flourishing: Do trust in the organization and organizational support matter during times of uncertainty?
Authors: Kleynhans Deon J. , Heyns Marita M. , Stander Marius W. 
Published: September 2022

Orientation: This study investigated the influence of authentic leadership on employee flourishing while considering the potential mediating effect of trust in the organization and organizational support as underlying mechanisms in an uncertain setting.Research purpose: To examine the relationship between authentic leadership and employee flourishing by evaluating the indirect effect of organizational support and trust in the organization as potential mediators.Motivation for the study: An authentic leadership approach, organizational support, and trust in the organization may influence the flourishing of employees in uncertain times. Increasing the comprehension of the possible interaction effect of organizational support and trust in the organization in the relationship between authentic leadership and employee flourishing may improve individual and organizational efficiency.Research approach/design and method: A quantitative, cross-sectional survey design was applied in this study. The sample comprised 314 employees in a noteworthy South African steel manufacturing entity. The Authentic Leadership Inventory, Workplace Trust Survey, Flourishing-at-Work Scale, and the Job Demands-Resources Scale were administered.Main findings: The findings of this study suggest that authentic leadership was a significant predictor of employee flourishing through organizational support and trust in the organization.Practical/managerial implications: This research illuminates the potential value-adding contribution of an authentic leadership style in promoting a trust-filled relationship between team members and their organization and the support they experience from their employer. Despite the prevailing precarious context, working under the mentioned conditions might result in the increased flourishing of employees.Contribution/value-add: The analyses of the mentioned relationships might assist businesses in optimizing the resources required to improve employee and organizational performance. Additionally, the exploration of organizational support in conjunction with organizational trust raises our understanding of the possible influence these elements can have in enhancing employee flourishing in the workplace.
Effects of adjunctive pimavanserin and current antipsychotic treatment on QT interval prolongation in patients with schizophrenia
Authors: Bugarski-Kirola Dragana , Nunez Rene , Odetalla Ramzey , Liu I-Yuan , Turner Mary Ellen 
Published: September 2022

BackgroundPimavanserin prolongs the QT interval, with mean increases in corrected QT (QTc) of 5–8 ms, and is currently being investigated for the treatment of negative symptoms of schizophrenia.ObjectivesTo assess QT interval prolongation in 3 studies investigating once-daily pimavanserin as an adjunct to current antipsychotic treatment in patients with schizophrenia.MethodsElectrocardiograms were unblinded from trials in which pimavanserin or placebo was added to main antipsychotics over 6 weeks (ENHANCE), 26 weeks (ADVANCE), and up to 78 weeks (ongoing 52-week, open-label extension study [study 035]) of treatment. Antipsychotic treatment was permitted throughout these studies. The 3 most frequently used antipsychotic treatments were examined—aripiprazole (including long-acting injectable), risperidone (including long-acting injectable), and olanzapine. QT intervals were corrected (QTc) using Fridericia's method, with elevated risk defined as either postbaseline value maximum of &gt;500 ms or change from baseline to postbaseline maximum of &gt;60 ms.ResultsOf patients treated with adjunctive pimavanserin in ENHANCE, there were no postbaseline QTc values &gt;481 ms; one patient in each of the risperidone and aripiprazole groups had change from baseline to postbaseline maximum &gt;60 ms. More patients had change from baseline to postbaseline maximum ranging from 31 to 60 ms in the risperidone plus adjunctive placebo group (n = 5; 6.6%) than those in the risperidone plus adjunctive pimavanserin group (n = 3, 4.1%). In the pimavanserin plus antipsychotic group of ADVANCE, one patient had postbaseline QTc value &gt;481 ms, and one patient treated with aripiprazole had change from baseline to postbaseline maximum of &gt;60 ms. In study 035, a change from double-blind baseline to overall postbaseline maximum &gt;60 ms occurred in one patient treated with aripiprazole and pimavanserin and in one patient treated with risperidone and pimavanserin. Similar proportions of patients had changes from double-blind baseline to post double-blind baseline maximum between 31 and 60 ms across treatments. No adverse events associated with an increase in the QTc interval were reported.ConclusionsAdjunctive pimavanserin with background antipsychotic treatment showed no evidence of QTc prolongation &gt;500 ms postbaseline, consistent with previously reports on QT prolongation with pimavanserin.
Prevalence and associated factors of obesity and overweight in Chinese patients with bipolar disorder
Authors: Yi Wenying , Wu Haibo , Li Ruikeng , Li Haijing , Song Zhen , She Shenglin , Zheng Yingjun 
Published: September 2022

ObjectDespite abundant literature demonstrating a high prevalence of obesity and overweight in people with bipolar disorder (BD), little is known about this topic in China. Therefore, we assessed the prevalence and associated factors of obesity and overweight among inpatients with BD in our hospital, one of the largest public psychiatric hospitals in China.MethodsIn this retrospective, cross-sectional study, 1,169 inpatients ≥18 years with BD during 2019 were included. Obesity was defined as having a BMI ≥25 kg/m2, and overweight was defined as having a BMI from 23 kg/m2 to &lt;25 kg/m2. Binary logistic regression analysis was performed to identify factors associated with obesity and overweight.ResultsThe prevalence of obesity and overweight was 21.0% and 32.2% in patients with BD, respectively. Compared to patients with overweight and normal weight, patients with obesity were older, had a longer duration of BD and a longer length of hospital stay, had a higher prevalence of diabetes and hypertension, and had a higher level of all metabolic indices, except for HDL cholesterol. Binary logistic regression analysis showed that duration of BD, uric acid, alanine aminotransferase (ALT), triglyceride, and LDL cholesterol were significantly associated with obesity, and male sex and uric acid level were significantly associated with overweight (p &lt; 0.05).ConclusionsObesity and overweight were fairly prevalent in Chinese BD patients, and several factors were related to obesity and overweight. The results of the present study call for the need to implement early screening, prevention and interventions for obesity and overweight in patients with BD in China.
A case report on mixed pulmonary infection of Nocardia nova, Mycobacterium tuberculosis, and Aspergillus fumigatus based on metagenomic next-generation sequencing
Authors: Yan Haiming , Li Zhandong , Xia Han , Li Qixin , Bai Honglian 
Published: September 2022

BackgroundPulmonary infection is one of the common complications of long-term use of glucocorticoids. Severe infections not only increase the length of hospital stay and treatment costs but also cause progression or recurrence of the primary disease.Case descriptionHerein, we reported a case of mixed pulmonary infection secondary to glucocorticoid use. Rare pathogens such as Nocardia nova, Mycobacterium tuberculosis, Aspergillus fumigatus, and cytomegalovirus were detected by metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid and lung puncture tissue. Combining the results of conventional pathogen detection and clinical symptoms, the patient was diagnosed with mixed pulmonary infection by multiple pathogens. After timely targeted medication, the patient was finally discharged with a good prognosis.ConclusionTo our knowledge, this is the first case report on mixed pulmonary infection with pathogens including Nocardia nova, Mycobacterium tuberculosis, Aspergillus fumigatus, and human cytomegalovirus. As a new clinical diagnostic method, mNGS has great advantages in diagnosis of diseases such as mixed infections.