bluuebunny/crossref_metadata_2025_split huggingface dataset:
Withania somnifera (L.) Dunal as Add-On Therapy for COPD Patients: A Randomized, Placebo-Controlled, Double-Blind Study
Authors: Singh Priyam , Salman Khushtar Anwar , Shameem Mohammad , Warsi Mohd Sharib 
Published: June 2022

Background:The current gold-standard therapies for chronic obstructive pulmonary disease (COPD) lack disease-modifying potential and exert adverse side effects. Moreover, COPD patients are at a higher risk of severe outcomes if they get infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, the cause of the current epidemic. This is the first study to document clinical research on an adaptogenic and steroidal activity–containing herb as a complementary medicine for COPD treatment.Objective:We aimed to evaluate the efficacy ofWithania somnifera(L.)Dunal[Solanaceae] (WS) as an add-on therapy for COPD patients.Methods:A randomized, placebo-controlled, and double-blind clinical study was conducted. A total of 150 patients were randomly assigned to three groups: control, placebo, and WS group. In addition to conventional medicines, WS root capsules or starch capsules were given twice a day to the WS group and the placebo group, respectively. Their lung functioning, quality of life, exercise tolerance, systemic oxidative stress (OS), and systemic inflammation were assessed before and after 12 weeks of intervention. WS root phytochemicals were identified by LC-ESI-MS. The inhibitory activity of these phytochemicals against angiotensin-converting enzyme 2 (ACE-2); the SARS-CoV-2 receptor; myeloperoxidase (MPO); and interleukin-6 (IL-6) was evaluated byin silicodocking to investigate the mechanism of action of WS.Results:The pulmonary functioning, quality of life, and exercise tolerance improved, and inflammation reduced notably the most in the WS group. Systemic oxidative stress subsided significantly only in the WS group. Although a minor placebo effect was observed in the SGRQ test, but it was not present in other tests. Withanolides found in the WS roots demonstrated substantial inhibitory activity against the proteins ACE-2, MPO, and IL-6, compared to that of a standard drug or known inhibitor. Moreover, FEV1% predicted had significant correlation with systemic antioxidative status (positive correlation) and malondialdehyde (MDA, negative correlation), suggesting that the antioxidative potential of WS has significant contribution to improving lung functioning.Conclusion:Our study clinically demonstrated that WS root when given along with conventional drugs ameliorated COPD significantly more in comparison to the conventional drugs alone, in GOLD 2 and 3 categories of COPD patients.In silico, it has potent inhibitory activity against SARS-CoV-2 receptor, ACE-2, MPO, and IL-6.
Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study
Authors: Nunes Patricia Helena Castro , Moreira Jessica Pronestino de Lima , Thompson Alessandra de Figueiredo , Machado Thalita Lyrio da Silveira , Cerbino-Neto José , Bozza Fernando Augusto 
Published: June 2022

Background: The consumption of antibiotics is one of the metrics used to evaluate the impact of antimicrobial stewardship programs (ASP). The aim of this study was to determine the prevalence of antibiotic consumption in Brazilian intensive care units (ICUs) and estimate the deviation of the prescribed daily dose (PDD) from the defined daily dose (DDD).Methods: This is a multicenter, observational, point-prevalence study carried out in adult ICUs of 8 Brazilian hospitals from August 2019, to February 2020. We collected data on the patient’s demographic and clinical characteristics, antibiotic therapy, classification and site of infections. The DU90 (antibiotic accounting for 90% of the volume utilized) was calculated, and the antibiotics were classified by the Anatomical Therapeutic Chemical (ATC) Index and the World Health Organization (WHO) Access, Watch, Reserve (AWaRe) groups. For the most prevalent antibiotics, the deviation of PDD from DDD was determined.Results: Three hundred thirty-two patients from 35 ICUs were analyzed. The prevalence of antibiotic use was 52.4%. The patients in use of antibiotics were predominantly over 60 years of age (81.6%) with pulmonary infections (45.8%). A predominance of empirical regimens was observed (62.6%) among antibiotic therapies. The highest frequencies of prescriptions observed were for piperacillin + tazobactam (16.1%), meropenem (13.3%), amoxicillin + clavulanate (7.2%), azithromycin (7.2%), and teicoplanin (6.1%). The watch (64.2%) and reserve (9.6%) categories of the AWaRe classification accounted for 73.8% of all antibiotics, and they were prescribed alone or in combinations. High variability of doses was observed for the most prescribed antibiotics, and large deviations of PDD from the DDD were observed for meropenem, teicoplanin, and tigecycline.Conclusions: The high prevalence of antibiotic prescription was related to a predominance of empirical regimens and antibiotics belonging to the WHO Watch classification. High variability of doses and large deviations of PDD from DDD for meropenem, teicoplanin, and tigecycline was observed, suggesting that DDD may be insufficient to monitor the consumption of these antibiotics in the ICU population. The variability of doses found for the most prescribed antibiotics suggests the need for monitoring and intervention targets for antibiotic stewardship teams.
Antidepressant Active Ingredients From Chinese Traditional Herb Panax Notoginseng: A Pharmacological Mechanism Review
Authors: Li Yanwei , Guo Qingwan , Huang Junqing , Wang Ziying 
Published: June 2022

Depression is one of the most common mental illnesses in the world and is highly disabling, lethal, and seriously endangers social stability. The side effects of clinical drugs used to treat depression are obvious, and the onset time is longer. Therefore, there is a great demand for antidepressant drugs with better curative effects, fewer side effects, and shorter onset time. Panax notoginseng, a Chinese herbal medication, has been used to treat depression for thousands of years and shown to have a therapeutic effect on depression. This review surveyed PubMed’s most recent 20 years of research on Panax notoginseng’s use for treating depression. We mainly highlight animal model research and outlined the pathways influenced by medicines. We provide a narrative review of recent empirical evidence of the anti-depressive effects of Panax Notoginseng and novel ideas for developing innovative clinical antidepressants with fewer side effects.
Hybrid Nd:YAG/Nd:LuAG Nanosecond Laser Oscillator and Amplifier
Authors: Lei Xinxing , Fu Xing , Liu Qiang 
Published: June 2022

We demonstrate an active mirror Q-switched laser with Nd:YAG/Nd:LuAG hybrid gain media, achieving a laser output of 1 J, 10 Hz, 8 ns. Using this hybrid oscillator as well as Nd:YAG and Nd:LuAG amplifiers, the difference in extraction efficiency of hybrid amplification was measured and analyzed, which is useful for high-energy hybrid amplification chains.
Comparison of Hemodynamic Brain Responses Between Big Wave Surfers and Non-big Wave Surfers During Affective Image Presentation
Authors: Showstark Mary , Bahadursingh Ryan , Zhang Sheng , Fry Adam , Kozminski Barbara , Lundstam Per , Putrino David 
Published: June 2022

BackgroundBig wave surfers are extreme sports athletes who expose themselves to life-threatening risk when training and competing. Little is known about how and why extreme sports athletes choose to participate in their chosen sports. This exploratory study investigated potential neurophysiological and psychometric differences between big and non-big wave surfers.MethodsThirteen big wave surfers (BWS) and 10 non-big wave surfers (CON) viewed a series of images from the International Affective Picture System (IAPS) while undergoing brain functional magnetic resonance imaging (fMRI). The Fear Schedule Survey-III, Arnett Inventory of Sensation Seeking, Discrete Emotions Questionnaire, and Positive and Negative Affect Schedule were also completed.ResultsThe BWS group demonstrated higher blood-oxygen level-dependent (BOLD) signal change in the insula, visual cortex, and periaqueductal gray, whereas the CON group displayed increased hypothalamus activation in response to high amplitude negative-valence (HAN) image presentation. Psychophysiological interaction (PPI) analyses found CON showed significant interactions between frontal and temporal cortical regions as well as between the hypothalamus and the insula, frontal, and temporal cortices during HAN image presentation that were not seen in BWS. No differences between groups were found in their responses to the questionnaires.ConclusionOur findings demonstrate significant differences in brain activation between BWS and CON in response to the presentation of HAN IAPS images, despite no significant differences in scores on psychometric questionnaires.
Medication Gaps and Antipsychotic Polypharmacy in Previously Hospitalized Schizophrenia Patients: An Electronic Cohort Study in Three Canadian Provinces
Authors: Peters Evyn , Shamloo Arash , Lodhi Rohit J. , Marcoux Gene , Jackson Kylie , Halayka Shawn , Balbuena Lloyd 
Published: June 2022

BackgroundReal world evidence about antipsychotics focuses on rehospitalization. Modeling the time course of pharmacotherapy would show patients' adherence to medications and physicians' adherence to medication guidelines. We aimed to calculate the cumulative time spent in second generation antipsychotics (SGAs), gaps, antipsychotic polypharmacy, and clozapine in discharged schizophrenia patients.MethodsHospitalization and pharmacy dispensing data from 2008–2018 in Manitoba, Saskatchewan, and British Columbia were linked and an electronic cohort (N = 2,997) was created (mean follow-up: 49 months, SD = 38). Cohort members were required to have a minimum of 6 weeks medicated with aripiprazole, olanzapine, paliperidone, quetiapine, risperidone, or ziprasidone.ResultsThe multistate model predicted that schizophrenia patients accumulated 44 months in SGA monotherapy, 4 months in polypharmacy, 11 months in medication gaps and 17 days in clozapine over a 5-year period. The majority of transitions were between SGA and medication gap. Accumulated time in medication gaps was seven times as much as in clozapine. Each 10% delay in SGA initiation post-discharge was associated with a 2, 1, and 6% higher risk for polypharmacy (95% CI: 1.01–1.02), gap (95% CI: 1.01–1.01), and clozapine (95% CI: 1.04–1.08), respectively.InterpretationSchizophrenia patients accumulated more time unmedicated and in polypharmacy compared to clozapine. Either treatment guidelines for schizophrenia are not followed, or real-world challenges hamper their implementation.
How Different Pre-existing Mental Disorders and Their Co-occurrence Affects COVID-19 Clinical Outcomes? A Real-World Data Study in the Southern United States
Authors: Qiao Shan , Zhang Jiajia , Chen Shujie , Olatosi Bankole , Hardeman Suzanne , Narasimhan Meera , Bruner Larisa , Diedhiou Abdoulaye , Scott Cheryl , Mansaray Ali , Weissman Sharon , Li Xiaoming 
Published: June 2022

BackgroundAlthough a psychiatric history might be an independent risk factor for COVID-19 infection and mortality, no studies have systematically investigated how different clusters of pre-existing mental disorders may affect COVID-19 clinical outcomes or showed how the coexistence of mental disorder clusters is related to COVID-19 clinical outcomes.MethodsUsing a retrospective cohort study design, a total of 476,775 adult patients with lab-confirmed and probable COVID-19 between March 06, 2020 and April 14, 2021 in South Carolina, United States were included in the current study. The electronic health record data of COVID-19 patients were linked to all payer-based claims data through the SC Revenue and Fiscal Affairs Office. Pre-existing mental disorder diagnoses from Jan 2, 2019 to Jan 14, 2021 were extracted from the patients' healthcare utilization data via ICD-10 codes.ResultsThere is an elevated risk of COVID-19-related hospitalization and death among participants with pre-existing mental disorders adjusting for key socio-demographic and comorbidity covariates. Co-occurrence of any two clusters was positively associated with COVID-19-related hospitalization and death. The odds ratio of being hospitalized was 1.26 (95% CI: 1.151, 1.383) for patients with internalizing and externalizing disorders, 1.65 (95% CI: 1.298, 2.092) for internalizing and thought disorders, 1.76 (95% CI: 1.217, 2.542) for externalizing and thought disorders, and 1.64 (95% CI: 1.274, 2.118) for three clusters of mental disorders.ConclusionsPre-existing internalizing disorders and thought disorders are positively related to COVID-19 hospitalization and death. Co-occurrence of any two clusters of mental disorders have elevated risk of COVID-19-related hospitalization and death compared to those with a single cluster.
Impact of the COVID-19 Pandemic on the Effectiveness of a Metabolic Health Telemedicine Intervention for Weight Loss: A Propensity Score Matching Analysis
Authors: Athinarayanan Shaminie J. , Adams Rebecca N. , VanTieghem Michelle , McKenzie Amy L. , Volk Brittanie M. , Ratner Robert E. , Phinney Stephen D. 
Published: June 2022

BackgroundCoronavirus disease 2019 (COVID-19) pandemic public health measures such as stay-at-home and mandatory work-from-home orders have been associated with obesogenic lifestyle changes, increased risk of weight gain, and their metabolic sequelae. We sought to assess the impact of this pandemic on weight loss from a telemedicine-delivered very-low-carbohydrate intervention targeting nutritional ketosis (NKI).MethodsA total of 746 patients with a BMI ≥25kg/m2, enrolled between January and March 2020 and treated for at least 1 year with the NKI, were classified as pandemic cohort (PC). A separate cohort of 699 patients who received 1 year of the NKI in the preceding years, enrolled between January and March 2018, were identified as pre-pandemic cohort (Pre-PC). Demographic and clinical data were obtained from medical records to compare the cohorts and assess the outcomes. Using propensity score matching (PSM), balanced and matched groups of 407 patients in the Pre-PC and 407 patients in the PC were generated. Longitudinal change in absolute weight and percentage weight change from baseline to 1 year were assessed.ResultsWeight significantly decreased in both PC and Pre-PC at 3, 6, 9, and 12 months. The weight loss trajectory was similar in both PC and Pre-PC with no significant weight differences between the two cohorts at 3, 6, 9, and 12 months. On an average, the PC lost 7.5% body weight while the Pre-PC lost 7.9% over 1 year, and the percent weight loss did not differ between the two cohorts (p = 0.50).ConclusionA very-low-carbohydrate telemedicine intervention delivered comparable and medically significant weight loss independent of pandemic stress and lifestyle limitations.
Quality of Life, Hopelessness, Impulsivity, and Suicide in the Rural Elderly in China: A Moderated Mediation Analysis of Psychological Autopsy Data
Authors: Chen Guoxiang , Mo Qiqing , Chen Xinguang , Yu Bin , He Huiming , Wang Guojun , Jia Cunxian , Zhou Liang , Ma Zhenyu 
Published: June 2022

BackgroundPeople who had died by suicide always being associated with negative emotions and even mental disorders. Understanding mechanisms underlying the association between quality of life (QOL), hopelessness, and suicide are of great significance. In this study, we aimed to test a model in which the QOL-suicide relationship was mediated by hopelessness and moderated by impulsivity.MethodsParticipants (N = 484, including 242 suicide deaths and 242 matched controls) were rural residents 60 years of age and older, randomly selected from 12 rural counties in China using a two-stage stratified cluster sampling method. Data were collected with standard psychological autopsy technique from informants (n = 968). The outcome variable was a suicide death. QOL, hopelessness, and impulsivity were assessed using validated scales. The proposed relationships were tested using mediation and moderated mediation models.ResultsOf the total sample, 55.8% were men with a median age of 75.5 years. Results from the moderated mediation analysis indicated that QOL was negatively associated with suicide (beta = −0.141, p &lt; 0.01); this association was mediated by hopelessness (indirect effect: beta =0.578, p &lt; 0.01), accounting for 73% of the total effect. Impulsivity significantly moderated the mediation effect from QOL to hopelessness (beta =0.005, p &lt; 0.01).ConclusionsStudy findings have confirmed the negative association between QOL and suicide with psychological autopsy data, and demonstrated the role of hopelessness in mediating the QOL-suicide relation that is further modified by impulsiveness. These findings depend on our understanding of the suicide epidemiology among the elder in rural China and provide information much needed for suicide prevention.
The Relationship Between Occupational Stress and Turnover Intention Among Emergency Physicians: A Mediation Analysis
Authors: Jiang Nan , Zhang Hongling , Tan Zhen , Gong Yanhong , Tian Mengge , Wu Yafei , Zhang Jiali , Wang Jing , Chen Zhenyuan , Wu Jianxiong , Lv Chuanzhu , Zhou Xuan , Yang Fengjie , Yin Xiaoxv 
Published: June 2022

BackgroundThere is evidence that occupational stress is a risk factor for turnover intentions. However, the structural relationship between occupational stress and turnover intention among emergency physicians has rarely been studied. This study aimed to examine the pathways of occupational stress on turnover intention through job satisfaction and depressive symptoms among emergency physicians in China.MethodsA cross-sectional study was conducted in China from July 2018 to August 2018. Data were collected using a structured questionnaire that included demographic characteristics, occupational stress, job satisfaction, depressive symptoms, and turnover intention. Hierarchical linear regression was performed to explore the related factors of turnover intention. Structural equation modeling was used to examine the pathways from occupational stress to turnover intention.ResultsA total of 10,457 emergency physicians completed the questionnaire. The score of turnover intention was 11.34 (SD = 3.25), and the average item score of turnover intention was 2.84 (SD = 0.81). In structural equation modeling, the occupational stress not only had a direct effect on turnover intention (standardized direct effect = 0.311, bias-corrected 95% confidence interval [0.261, 0.361], P &lt; 0.001), but also had an indirect effect through job satisfaction and depressive symptoms (standardized indirect effect = 0.448, bias-corrected 95% confidence interval [0.412, 0.484], P &lt; 0.001). However, the effect of depressive symptoms on turnover intention was weak (standardized coefficient [β] = 0.08, P &lt; 0.001).ConclusionsJob satisfaction partially mediated the relationship between occupational stress and turnover intention. However, due to the weak effect of depressive symptoms on turnover intention, the mediating role of depressive symptoms between occupational and turnover intention had little practical value. It is recommended that hospital administrators prioritize increasing job satisfaction of emergency physicians to reduce the impact of occupational stress on their turnover intention.
Robotic Staging of Cervical Cancer With Simultaneous Detection of Primary Pelvic and Secondary Para-Aortic Sentinel Lymph Nodes: Reproducibility in a First Case Series
Authors: Van Trappen Philippe , De Cuypere Eveline , Claes Nele , Roels Sarah 
Published: June 2022

ObjectiveDiscrepancies exist among international guidelines on the surgical staging of para-aortic lymph nodes in locally advanced cervical cancer (LACC), varying from considering a para-aortic lymph node dissection, at least up to the inferior mesenteric artery, to a complete para-aortic lymph node dissection. In this study, we aim to assess the reproducibility of our recently reported robotic technique using indocyanine green for identifying besides primary pelvic sentinel lymph nodes (SLNs), secondary para-aortic SLNs in a first case-cohort of cervical cancer patients.MethodsA retrospective case series of LACC patients with/without suspicious pelvic lymph nodes (LNs) on imaging (including two patients with an additional suspicious para-aortic LN) is reported. All patients underwent a robotic pelvic SLN and para-aortic sentinel/nonsentinel LN dissection using the da Vinci Xi platform. Indocyanine green was used as a fluorescent tracer, at a concentration of 1.9 mg/mL, and injected as 0.5 mL in each quadrant of the cervix.ResultsIn a total of 10 cases, primary pelvic SLNs (90% bilateral) with subsequent secondary para-aortic SLNs were identified in all cases. Lower para-aortic SLNs were present in all cases, and upper para-aortic SLNs were found in 9 out of 10 cases. The mean age of the cervical cancer patients was 49.8 years (SD ± 6.89), and the mean body mass index (BMI; kg/m2) was 23.96 (SD ± 4.60). The median total operative time was 105.5 min (range: 89–141 min). The mean numbers of primary pelvic SLNs and secondary lower and upper para-aortic SLNs were 3.10 (SD ± 1.10), 2.90 (SD ± 0.74), and 2.30 (SD ± 1.57), respectively. The median number of total para-aortic LNs (PALNs) dissected per patient was 11.5. Six patients had positive primary pelvic SLNs, and two had secondary positive para-aortic SLNs. The nonsentinel para-aortic LNs were negative in all cases. There were no intra- or postoperative complications.ConclusionOur preliminary experience demonstrates the reproducibility of identifying, besides primary pelvic SLNs, secondary lower and upper para-aortic SLNs during robotic staging in LACC. A surgical approach limiting a complete para-aortic LN dissection could reduce the potential risks and morbidity associated with this procedure. To determine the sensitivity and negative predictive value of this new surgical approach, and whether the lower para-aortic SLNs under the inferior mesenteric artery are representative of the whole para-aortic region, large prospective observational studies are needed in LACC and/or those with suspicious pelvic LNs but apparent normal para-aortic LNs on imaging.
Perkembangan Ekonomi Digital Mengenai Perilaku Pengguna Media Sosial Dalam Melakukan Transaksi
Authors: Rifai Danang , Fitri Sania , Ramadhan Irma Nirmala 
Published: June 2022

Perkembangan ekonomi digital terkait dengan perilaku pengguna jejaring sosial dalam bertransaksi Pesatnya perkembangan teknologi informasi dan telekomunikasi berdampak signifikan terhadap perilaku konsumen di dunia, pemilihan dan keputusan pembelian. Teknologi informasi memungkinkan untuk melakukan berbagai aktivitas secara cepat, akurat, tanpa batasan waktu dan tempat, sehingga diharapkan dapat meningkatkan efisiensi dan produktivitas. Perubahan perilaku konsumen mengenai cara pengumpulan informasi dan transaksi pembelian dan penjualan yang dilakukan harus terus diperiksa untuk mendapatkan informasi yang akurat tentang keinginan dan kebutuhan konsumen. Di Indonesia sangat berpotensi mempengaruhi perkembangan dunia teknologi. Perkembangan teknologi telah muncul di berbagai jenis bidang, terutama dalam perkembangan ekonomi digital. Ekonomi digital memiliki dampak positif dan negatif bagi pembangunan Indonesia. Dampak Perkembangan Ekonomi Digital menjadi wadah tersendiri bagi pemerintah atau masyarakat untuk menjadi wadah dalam melakukan berbagai jenis transaksi ekonomi. Tujuan dari penelitian ini adalah untuk menganalisis dampak perkembangan ekonomi digital terhadap pengguna media sosial dalam melakukan transaksi. Hasil dari penelitian ini adalah berkembangnya perusahaan periklanan, dan banyak perusahaan atau bisnis online yang menerapkan promosi penjualan di jejaring sosial untuk produknya, sehingga sangat membantu dalam mempromosikan dan memperluas audience.