bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency, severity, and factors associated with clinically significant drug-drug interactions among patients with cancer attending Mbarara Regional Referral Hospital Cancer Unit, Uganda
Authors: Luzze Bonny , Atwiine Barnabas , Lugobe Henry Mark , Yadesa Tadele Mekuriya 
Published: December 2022

AbstractBackgroundCancer is a major public health problem with pharmacotherapy being the cornerstone of its management. Cancer patients receive multiple drugs concurrently risking Drug-Drug Interactions (DDIs). DDIs, though avoidable, can significantly contribute to morbidity, mortality, and increased healthcare costs in this population of patients. Currently, there is no published study from Uganda on clinically significant DDIs (cs-DDIs) among cancer patients. This study identifies frequency, severity, and factors associated with cs-DDIs at Mbarara Regional Referral Hospital Cancer Unit (MRRHCU).MethodA cross-sectional study was conducted among 300 cancer patients receiving chemotherapy from a tertiary care hospital in western Uganda from January–February 2022. A questionnaire and data collection form were used to collect patient data. Lexicomp® Drug interaction software was used to screen the patient drug information for DDIs and assess their severity. Predictors of DDIs were identified using logistic regression using SPSS (Statistical Package for Social Sciences).ResultThree hundred participants were enrolled with a mean age of 48 ± 23.3 years. One hundred eighty-one patients experienced 495 cs-DDIs; with a mean of 1.7 ± 2.2. The prevalence of cs-DDI was 60.3% (55.0-66.0% at 95% CI). Digestive organ neoplasms were the most commonly (80, 26.7%) diagnosed category, and ‘plant alkaloids and other natural products were the most frequently (143, 47.7%) used chemotherapeutic drug classes. About three-quarters of cs-DDIs were rated as category C risk (367, 74.1%) whereas over two-thirds (355, 71.7%) were moderate in severity.. Being female (aOR = 2.43 [1.23–4.48 at 95% CI];P-value = 0.011) and use of ≥ 6 drugs concurrently (aOR = 18.82 [9.58–36.95 at 95% CI];P-value < 0.001)) were significantly associated with cs-DDIs.ConclusionMore than half of the participants experienced at-least one cs-DDI which is generally higher than what was reported in high-income settings. About three-quarters were category C and moderate in severity, and require enhanced monitoring for safety and treatment outcome. Being female and using ≥ 6 drugs were significantly associated with cs-DDIs.
Atrophy of retinal vessels in neovascular age-related macular degeneration following long-term treatment with 20 intravitreal anti-VEGF injections
Authors: Resch Miklós D. , Balogh Aniko , Kurth Tilmann , Nagy Zoltán Z. , DeBuc Delia Cabrera , Papp András 
Published: December 2022

Abstract
Background
The study aimed to evaluate the changes in retinal vascular density in exudative age-related macular degeneration (AMD) after long-term anti-VEGF treatment using optical coherence tomography angiography (OCT-A), and to compare these changes with the vascular density in AMD treated for one year and healthy eyes.

Methods
In our cross-sectional study OCT-A was performed on 60 eyes of 60 patients. Group AMD 20 × consisted of patients receiving long-term (minimum 20 injections) aflibercept therapy (n = 17), and Group AMD one year consisted of patients treated for one year with a treat & extend protocol (n = 25). The vascular density values obtained with OCT-A were compared with an age-matched control group of 18 healthy eyes. We examined the central retinal thickness (CRT), the vascular density of the fovea and parafovea in the superficial and deep retinal plexus, and evaluated the extent of the non-flow area and the foveal avascular zone (FAZ) on a 3 × 3 mm macular region. Kruskal–Wallis test was performed for statistical analysis.

Results
In Group AMD 20x, the vascular density of superficial retinal plexus in the fovea (p = 0.0022) and parafovea (p < 0.0001) was significantly lower compared to Group one year and control group. In the deep retinal plexus, vascular density in the fovea (p = 0.0033) was significantly lower in both AMD groups compared to the control group, with no difference in the parafoveal region (p = 0.0774). The extent of non-flow area (p = 0.0003) and FAZ (p = 0.0008) were significantly larger in both AMD groups compared to the control group. There was a significant difference in CRT between those treated for one year and control eyes (p = 0.0036).

Conclusions
In our study, we demonstrated that macular vessel density was lower in the foveal area in the superficial retinal plexus in AMD patients after one year and long-term anti-VEGF treatment. These vascular density changes were absent in the parafoveal and whole areas of the deep retinal plexus. Our results indicate that long-term anti-VEGF treatment reduces the vascular density of the superficial retinal plexus to a greater extent compared to the deep retinal plexus.
Within- and cross-mental health disorder correlations in husband-and-wife pairs
Authors: Merrill Ray M. 
Published: December 2022

Abstract
Background
Mental health disorders can adversely affect relationships and are heritable. Yet, there is a high prevalence of mental illness in spouses and partners of those with mental illness. This study will assess within- and cross-mental health disorder correlations in husband-and-wife pairs.

Methods
A cross-sectional study design was employed using medical claims data from the Deseret Mutual Benefit Administrators (DMBA), linked to demographic information from employee eligibility files, 2020. Analyses involved 21,027 contract holders aged 18–64 (68.6% male, 31.4% female), with sub-analyses on 16,543 married individuals. Summary statistics, as well as rates, and rate ratios adjusted for age, sex, and dependent child status were calculated to describe the data.

Results
The rate of stress is 19.2%, anxiety is 26.4%, and depression is 23.6% in spouses of contract holders with the same respective disorders. Rates of stress, anxiety, and depression in a spouse are greatest if the contract holder has schizophrenia. Rates of mental illness in wives of male contract holders experiencing mental health disorders tend to be greater than the rates of mental illness in husbands of female contract holders experiencing mental health disorders. Rates of stress, anxiety, and depression in spouses of contract holders tend to be 2–3 times greater when the contract holder has a mental health disorder, after adjusting for the contract holder’s age, sex, dependent child status, and difference in age within husband-and-wife pairs. However, differences in the magnitude of observed associations vary. The rate of a spouse having stress is 5.5 times greater if the contract holder has schizophrenia (vs. does not have schizophrenia), whereas the rate of a spouse having stress is 1.4 times greater if the contract holder has sleep apnea (vs. does not have sleep apnea).

Conclusion
Mental health disorders in spouses of contract holders are greater if the contract holder has a mental health disorder, more so when the contract holder has more serious mental illness. Both within- and cross-mental disorder correlations exist. These results have implications on relationship quality and the mental health of offspring.
The usability and feasibility validation of the social robot MINI in people with dementia and mild cognitive impairment; a study protocol
Authors: Asl Aysan Mahmoudi , Toribio-Guzmán Jose Miguel , van der Roest Henriëtte , Castro-González Álvaro , Malfaz María , Salichs Miguel A. , Martin Manuel Franco 
Published: December 2022

Abstract
Background
Social robots have demonstrated promising outcomes in terms of increasing the social health and well-being of people with dementia and mild cognitive impairment. According to the World Health Organization’s Monitoring and assessing digital health interventions framework, usability and feasibility studies are crucial before implementing prototype social robots and proving their efficacy and effectiveness. This protocol paper aims to detail the plan for conducting the usability and feasibility study of the MINI robot based on evidence-based recommended methodology.

Methods
In this study, an experimental design and a mixed method of data collection will be applied. Twenty participants aged 65 and over with dementia or mild cognitive impairment will be recruited. Eight sessions of interaction with the robot, as well as qualitative and quantitative assessments, will be accomplished. The research will take place in a laboratory. Ethical approvals have been acquired. This research will be valuable in the development of the MINI robot and its practical deployment in the actual world, as well as the methodological evidence base in the sector of social robots.

Discussion
By the winter of 2022–2023, the findings of this study will be accessible for dissemination. This study will aid to improve the evidence-based methodology used to study the feasibility and usability of social robots in people with dementia and mild cognitive impairment as well as what can be learned to advance such study designs in the future.
Adherence to prescribed antihypertensive medication among patients with depression in the United States
Authors: Liu Quanjun , Wang Haochen , Liu Anbang , Jiang Cheng , Li Weiya , Ma Huan , Geng Qingshan 
Published: December 2022

Abstract
Background
Hypertensive patients with depression have a higher mortality rate and a worse prognosis compared with hypertensive only. Depression may reduce medication adherence in hypertension patients.

Methods
This study includes respondents in the National Health and Nutritional Examination Survey (NHANES) database from 2005 to 2018 who had previously been diagnosed with hypertension. Medication adherence was defined as taking medication as recommended by a physician. The depressive state was assessed using the patient health questionnaire (PHQ)-9.

Results
Nine thousand one hundred eighty-six respondents were included in the analysis. Medication adherence was associated with depression (odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.26 to1.75) and depression score (OR: 1.04 per each point increase, 1.03 to 1.05) in the unadjusted analyses. After adjusting for clinical and socioeconomic/demographic factors, there were significant statistical correlations between depression score and medication adherence (aOR: 1.02 per each point increase, 1.00 to 1.03, p < 0.05), but there was no significant statistical correlation between depression and medication adherence (p > 0.05). It was still statistically significant relationships between sex, age, body mass index (BMI), race, marital status, and health insurance with medication adherence after adjusted socioeconomic/demographic factors.

Conclusion
Depression was marginally associated with poor medication adherence in hypertensive patients, and the correlation increased with depression degree. Moreover, socioeconomic/demographic factors have an independent impact on medication adherence including sex, age, BMI, race, marital status, and health insurance.
Socioeconomic inequality in depression and anxiety and its determinants in Iranian older adults
Authors: Azizabadi Zahra , Aminisani Nayyereh , Emamian Mohammad Hassan 
Published: December 2022

AbstractBackgroundOlder adults with lower socioeconomic status are more vulnerable to stressful life events and at increased risk of common mental health disorders like anxiety and depression. This study investigates the socioeconomic inequality in depressive symptoms and anxiety.MethodsThe data were from 7462 participants of the Neyshabur longitudinal study of ageing registered during 2016-2018. The outcome variables were anxiety and depressive symptoms. Anxiety was defined by the “Hospital Anxiety and Depression scale Questionnaire”, and depressive symptoms was defined and measured by the “short-term form of the Epidemiological Center Questionnaire.” The socioeconomic status was defined using principal component analysis of home assets. The Concentration Index (C) was used to measure socioeconomic inequality in anxiety and depressive symptoms. Concentration index was decomposed to its determinants to determine the role of the independent variables on inequality.ResultsThe prevalence of depressive symptoms and anxiety was 12.2% (95% CI: 11.4, 12.9) and 7.0% (95% CI: 6.4, 7.5), respectively. Moreover, the C for anxiety was -0.195 (95% CI: -0.254, -0.136) and for depressive symptoms was -0.206 (95% CI: -0.252, -0.159), which indicate a considerable inequality in favor of high socioeconomic group for anxiety and depressive symptoms. Decomposition of the concentration Index showed that education, unemployment and male sex were the most important positive contributors to the observed inequality in anxiety and depressive symptoms, while age and number of grandchildren were main negative contributors of this inequality.ConclusionLow socioeconomic groups were more affected by anxiety and depressive symptoms. Any intervention for alleviation of inequality in anxiety and depression should be focus on education and employment of people, especially in younger elderly.
Reducing Khat use among Somalis living in Kenya: a controlled pilot study on the modified ASSIST-linked brief intervention delivered in the community
Authors: Widmann Marina , Apondi Bernice , Musau Abednego , Warsame Abdulkadir Hussein , Isse Maimuna , Mutiso Victoria , Veltrup Clemens , Schalinski Inga , Ndetei David , Odenwald Michael 
Published: December 2022

Abstract
Background
During recent decades, the consumption of the stimulant khat (catha edulis) has profoundly changed in countries around the Horn of Africa, and excessive use patterns have emerged—especially evident among displaced Somalis. This is related to the development of severe somatic and psychiatric disorders. There are currently no preventive or interventional studies targeting khat use. This study’s aim was to test screening and brief intervention (SBI) to reduce khat use among urban Somali refugees living in Kenya with limited access to public healthcare.

Methods
In this controlled study, 330 male Somali khat users from the community were either assigned to SBI (161) or an assessment-only control condition (AC; 169); due to field conditions a rigorous experimental design could not be implemented. The World Health Organization’s (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)-linked brief intervention was adapted to khat and Somali culture. Trained local counselors administered the intervention. The amount and frequency of khat use was assessed using the time-line-follow-back method. We compared the month before the intervention (t1) to the two months after it (t2, t3). Baseline differences in khat use frequency were corrected by partial matching and mixed effect models used to evaluate intervention effects.

Results
SBI was well accepted and feasible for khat users. Over the complete observation period and from t1 to t2, khat use amount and frequency decreased (p < .001) and the intervention group showed a greater reduction (group x time effects with p ≤ .030). From t2 to t3, no further reduction and no group differences emerged.

Conclusion
The results provide preliminary evidence that khat use amount and frequency can be reduced in community settings by SBI, requiring little resources. Thorough assessment alone might have intervention-like effects. The non-treatment-seeking community sample and the non-professional counselors are distinct from SBI studies with other substances in other countries, but support the feasibility of this approach in khat use countries and especially in Somali populations with limited access to healthcare. Future studies that employ rigorous experimental design are needed.

Trial registration
ClinicalTrials.gov identifier: NCT02253589. Date of first registration 01/10/2014, retrospectively registered https://clinicaltrials.gov/ct2/show/NCT02253589. First participant 16/09/2014:
Health literacy and digital health information-seeking behavior – a cross-sectional study among highly educated Swedes
Authors: Sundell Erica , Wångdahl Josefin , Grauman Åsa 
Published: December 2022

Abstract
Background
The benefits of digital development in health care may be obscured by unequal opportunities to make use of digital resources. The aim of this study was to investigate the association of health literacy with I) accessing health check test results in the Patient Electronic Health Record (PAEHR), II) searching for information to better understand individual test results, and III) using the national health information online portal provided by the Swedish national health care system.

Methods
This cross-sectional study included data from 434 individuals, 50–64 years old, randomly selected from the Swedish population during the year 2017 to a cohort study including health examination and a web-based survey. Health literacy was assessed at baseline using the Swedish Communicative and Critical Health Literacy scale. Digital information outcomes were assessed after three months. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) for the separate outcomes were computed using logistic regression. Covariates included sex, age, education, country of birth, cardiovascular risk factors at baseline, general health, risk perception, referral, and new cardiovascular risk factors detected at health examination.

Results
About a third of the participants (35%) had limited health literacy, while 65% had sufficient health literacy. Sufficient health literacy was associated with accessing the PAEHR (adjusted OR 1.81 95% CI 1.07–3.06) and use of the online national health information portal provided by the Swedish national health care system (adjusted OR 2.91 95% CI 1.13–7.52) but not with searching information to better understand individual test results (adjusted OR 1.29 0.75–2.20).

Conclusions
Individuals with limited health literacy do not access their personal health information nor search for health information on the online national health information portal provided by the Swedish national health care system to the same extent as individuals with sufficient health literacy. More research is needed about how the level of health literacy relates to differences in online health information-seeking behavior and how digital health information sources and e-health services can be designed to ensure that the entire population has equal access to trustworthy and quality-ensured health information.
Association of supply sources of alcohol and alcohol-related harms in adolescent drinkers: the baseline characteristics of a high school cohort across Thailand
Authors: Prasartpornsirichoke Jirada , Kalayasiri Rasmon , Vichitkunakorn Polathep , Ratta-apha Woraphat , Atsariyasing Wanlop , Anekwit Natwarat , Lamyai Warot , Thongpanich Chanchai , Likhitsathian Surinporn , Rungnirundorn Teerayuth , Rattanasumawong Wanida , Chuatai Nawapat , Srisuklorm Sakol , Tanaree Athip , Patanavanich Roengrudee 
Published: December 2022

Abstract
Background
The main objective of this study was to investigate the association between parental supply of alcohol, alcohol–related harms, and the severity of alcohol use disorder in Thai 7th grade middle school students.

Methods
A cross–sectional descriptive study obtained the baseline data from the project named the Thailand Parental Supply and Use of Alcohol, Cigarettes & Drugs Longitudinal Study Cohort in Secondary School Students in 2018. The sample size was 1187 students who have ever sipped or drank alcohol in the past 12 months. Pearson’s Chi square, binary logistic regression, and ordinal logistic regression are applied in the analysis.

Results
A single source of parental supply is not significantly associated with any alcohol-related harm and the severity of alcohol use disorder, while parental supply with peers and siblings supply of alcohol plays an important role in both outcomes. The increasing number of sources of alcohol supply increases the risk of alcohol–related harm and the severity of alcohol use disorder. Other risk factors found in both associations included binge drinking, alcohol flushing, low household economic status, distance from the student’s family, and poor academic performance. Gender, exposure to alcohol ads on social media and location of residency were not associated with alcohol–related harms or severity of alcohol use disorder.

Conclusions
The results did not support parental guidance in teaching or giving children a drink or sip of alcohol within family to prevent related harms when drinking outside with their peers.
Tissue plasminogen activator with prolonged dwell time effectively evacuates pleural effusions
Authors: Townsend Alexandra , Raju Harsha , Serpa Krystina A. , Pruett Rachel , Razi Syed S. , Tarrazzi Francisco A. , Tami Catherine M. , Block Mark I. 
Published: December 2022

AbstractObjectivesFibrinolytic therapy can be effective for management of complex pleural effusions. Tissue plasminogen activator (tPA, 10 mg) and deoxyribonuclease (DNAse) every 12 h with a dwell time of one hour is a common strategy based on published data. We used a simpler protocol of tPA (4 mg) without DNAse but with a longer dwell time of 12 h, repeated daily. We reviewed our results.MethodsCharts were reviewed and demographics, clinical data and treatment information were abstracted. Outcomes were assessed based on radiographic findings and need for surgery.ResultsTwo hundred and fifteen effusions in 207 patients (8 bilateral) were identified. 85% were either infectious or malignant. Two hundred and forty nine chest tubes were used: 84% were 10 Fr or 12 Fr and 7% were PleurX®. Five hundred and thirty one doses of tPA were given. The median number of doses per effusion was 2 (range 1–10), and 84% of effusions were treated with three or fewer doses. There were no significant bleeding complications. Median time to chest tube removal was 6 days (range 1 to 98, IQR 4 to 10). Drainage was considered complete for 78% of effusions, while 6% required decortication.ConclusionsLow dose tPA daily with a 12 h dwell time may be as effective as the standard regimen of tPA and DNAse twice daily with one hour dwell. For most patients only three doses were required, and small pigtail catheters were sufficient. This regimen uses less medication and is logistically much easier than the current standard.