bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Fat Mass to Lean Body Mass Ratio and All-Cause Mortality Among Middle-Aged and Elderly Cancer Patients Without Obesity: A Multi-Center Observational Study in China
Authors: Xue Hongmei , Du Hongzhen , Xie Ying , Zhai Yijing , Song Shiming , Luo Bin , Qiu Hong , Wang Kunhua , Cui Jiuwei , Song Chunhua , Xu Hongxia , Li Wei , Shi Hanping , Li Zengning ,   The Investigation on Nutrition Status and Its Clinical Outcome of Common Cancers (INSCOC) Group
Published: July 2022

ObjectiveWe aimed to investigate the association between fat mass to lean body mass ratio (RFL), percentage of body fat (PBF), and fat mass (FM) with mortality among middle-aged and elderly cancer patients without obesity.MethodsThis prospective hospital-based cohort study comprised 3,201 patients with stage I to IV cancer aged 40 years or above (mean age: 58 years for female patients and 61 years for male patients; mean length of follow-up was 1.67 years; the maximal follow-up length was 6.42 years). FM and PBF were measured by bioelectrical impedance analysis (BIA). Cox proportional hazard models were used, and adjusted hazard ratios (HRs) were estimated.ResultsWe revealed a significant association between RFL and all-cause mortality among men aged ≥60 years after adjusting for confounders. Compared with those in the lowest tertile of RFL, elderly men in the medium and highest tertile had a 35 and 34% lower hazard of death from any cause, respectively. After additionally adjusted for C-reaction protein (CRP), HRs of medium and high tertile of RFL became short of statistical significance [medium tertile: adjusted HRs (95% CI) = 0.74 (0.46, 1.20); highest tertile: adjusted HRs (95% CI) = 0.84 (0.53, 1.33)]. Among elderly women, RFL was significantly related to all-cause mortality only when the additional adjustment for CRP [medium tertile: adjusted HRs (95% CI) = 2.08 (1.08, 4.01); highest tertile: adjusted HRs (95% CI) = 0.90 (0.45, 1.81)]. No significant association between RFL and all-cause mortality was observed among female participants or male participants aged less than 60 years.ConclusionOur findings showed a significant non-linear association between RFL and all-cause mortality, which was observed only in elderly men, and might be attenuated by their inflammation state.
Laparoscopic Surgery for Focal-Form Congenital Hyperinsulinism Located in Pancreatic Head
Authors: Wen Zhe , Wang Jieqin , Liang Qifeng , Chang Xiaopan , Zhang Wen , Niu Huilin , He Qiao 
Published: July 2022

Background and AimsCongenital hyperinsulinism of infancy (CHI) is a rare condition that may cause irreversible severe neurological damage in infants. For children in whom medical management fails, partial or near-total pancreatectomy is then required according to the type of lesion. Currently, open surgery of near-total pancreatic head resection is a mature technique for the treatment of focal-form CHI located in the head of the pancreas, but a minimally invasive laparoscopic procedure has not been reported yet. The aim of this study was to verify the feasibility, safety, and efficacy of laparoscopic pancreatic head resection and Roux-en-Y pancreaticojejunostomy for focal-form CHI.MethodsTwo infants with persistent hypoglycemia and increased insulin levels were diagnosed with CHI and underwent laparoscopic near-total pancreatic head resection due to a suboptimal response to medical therapy and the likelihood of focal disease amenable to surgery. Clinical records, operative findings, and postoperative follow-up were collected and analyzed.ResultsThe operative duration was 300–330 min, and the intraoperative blood loss was minimal. The duration of postoperative abdominal drainage was 4–5 days. Neither intra- nor postoperative abdominal complications occurred. Oral feeding was resumed 3–4 days after the operation, and the blood glucose level was gradually stabilized to within the normal range. Normal blood glucose was observed in both patients over a follow-up period of 3–6 months.ConclusionsLaparoscopic pancreatic head resection and Roux-en-Y pancreaticojejunostomy can be considered a safe and effective procedure with minimal morbidity and excellent outcomes for the treatment of focal CHI in the head of the pancreas.
Call for Decision Support for High-Alert Medication Administration Among Pediatric Nurses: Findings From a Large, Multicenter, Cross-Sectional Survey in China
Authors: He Mengxue , Huang Qin , Lu Hong , Gu Ying , Hu Yan , Zhang Xiaobo 
Published: July 2022

Background: Children have a higher risk of medication errors (MEs) than adults. The Institute for Safe Medication Practice (ISMP) defined high-alert medications (HAMs) as a group of medications that could cause significant patient harm or even death when they are used in error. Nurses are actively involved in and responsible for patient care, especially in medication administration. This study aimed to estimate the knowledge, decision-making basis and confidence and decision support needs related to HAMs among pediatric nurses in China.Methods: A web-based, cross-sectional survey was conducted among pediatric nurses who were recruited from 14 member hospitals of the Pediatric Nursing Alliance of National Children’s Medical Center in China using a convenient sampling technique. Data were collected using a self-administered instrument composed of four parts: the demographic characteristics of participants, participants’ knowledge about HAMs, participants’ self-evaluation of the basis of and confidence in decision-making, and decision support needs regarding HAMs. Among the participants, the maximum score for HAM knowledge was 100. All data were entered and analyzed using SPSS 20.0.Results: A total of 966 nurses participated in this study. Nurses were found to have insufficient knowledge about HAMs, with a median (IQR) of 75.0 (70.0, 80.0), out of a maximum score of 100. Knowledge about HAM administration was significantly higher than that about HAM regulation, with a p value &lt; 0.001. The three lowest-scoring items concerned HAM regulation, and the “Treat fentanyl skin patches as a regulated narcotic” item obtained the lowest score, with only 1/5 of respondents answering it correctly. Most participants reported that their basis for decision-making about HAMs was drug instructions (90.0%) or drug handbooks (81.9%) and evaluated their confidence in decision-making about HAMs as high or relatively high (84.6%). The decision-making difficulties when encountering HAMs focused on most stages of HAM administration, especially the appropriateness of prescriptions, checks, preparation and administration. The vast majority of participants assessed decision support as necessary or very necessary (92.0%), and the most popular options for decision support were computerized clinical decision support systems (46.4%) and real-time online communication with pharmacists (23.9%).Conclusion: Our study demonstrated the inadequacies in HAM knowledge, the basis and difficulty of decision-making, and decision support needs regarding HAMs in Chinese pediatric nurses. Nurses need greater support in HAM administration, including not only training but also adequate technology, mutually beneficial interprofessional collaboration, and a positive institutional culture.
Evaluation of Herb–Drug Interaction Between Danshen and Rivaroxaban in Rat and Human Liver Microsomes
Authors: Wang Xu , Fa Jingjing , Zhang Yuanjin , Huang Shengbo , Liu Jie , Gao Junqing , Xing Lina , Liu Zongjun , Wang Xin 
Published: July 2022

The combination of Salvia miltiorrhiza (Danshen) and rivaroxaban is a promising treatment option in clinical practice in China, but the herb–drug interaction between Danshen and rivaroxaban remains unclear. Therefore, this study aims to reveal the interaction between Danshen and rivaroxaban. We not only investigated the inhibitory properties of Danshen tablet on rivaroxaban metabolism in rat and human liver microsomes but also evaluated the inhibitory effects of Danshen tablet and its eight active components (dihydrotanshinone I, tanshinone I, tanshinone IIA, cryptotanshinone, danshensu, salvianolic acid A, salvianolic acid B, and salvianolic acid C) on cytochrome P450 (CYP) enzymes. The results showed that Danshen tablet potently inhibited the metabolism of rivaroxaban in rat and human liver microsomes. In the CYP inhibition study, we found that dihydrotanshinone I, the active component of Danshen tablet, potently inhibited the activities of rat CYP3A and CYP2J, with IC50 values at 13.85 and 6.39 μM, respectively. In further inhibition kinetic study, we found that Danshen tablet is a mixed inhibitor in rivaroxaban metabolism in rat and human liver microsomes, with the Ki value at 0.72 and 0.25 mg/ml, respectively. In conclusion, there is a potential interaction between Danshen tablet and rivaroxaban. Danshen tablet inhibits the metabolism of rivaroxaban, which may be because its lipid-soluble components such as dihydrotanshinone I strongly inhibit the activities of CYP enzymes, especially CYP3A and CYP2J. Therefore, when Danshen tablet and rivaroxaban are used simultaneously in the clinic, it is necessary to strengthen the drug monitoring of rivaroxaban and adjust the dosage.
Early Effects of Repetitive Transcranial Magnetic Stimulation Combined With Sertraline in Adolescents With First-Episode Major Depressive Disorder
Authors: Chen Haisi , Hu Xiwen , Gao Jingfang , Han Huan , Wang Xiaole , Xue Chuang 
Published: July 2022

BackgroundAdolescence is a period of high incidence for depression. However, there is a limited treatment option for the adolescent depression. For treatment-resistant major depressive disorder, HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC) appears therapeutically effective. The aim of the study is to explore the early effects of repetitive transcranial magnetic stimulation in combination with sertraline in adolescents with first-episode major depressive disorder.MethodsA total of 100 teenage patients with first-episode depression were randomly divided into the study groups. Both groups were treated with sertraline. In addition, the study group was treated with ten sessions of add-on rTMS. The control group was given sertraline only. The depressive symptom and cognitive function were assessed by the Hamilton depression rating scale 17 version (HAMD-17), Children’s Depression Rating Scale-Revised (CDRS-R), Integrated visual and auditory continuous performance test (IVA-CPT), and THINC-it.ResultsThe number of early improvers after 2 weeks of treatment in the study group was statistically significant higher compared to the control group (95.83% vs 73.47%, χ2 = 9.277, P = 0.002). There was significant difference observed in responder rates (62.50% vs. 28.57%, χ2 = 11.262, P = 0.001) or in remission rates (31.25% vs. 6.12%, χ2 = 10.130, P = 0.001) between the two groups at 4 weeks. The score of HAMD-17 and CDRS-R in the study group were significantly lower than the control group (Fgroup = 12.91 vs 10.21, P &lt; 0.05). Attention Quotient (listening, visual and full-scale) attention quotient of IVA-CPT in the study group were higher than those in the control group after treatment, and the differences were statistically significant(P &lt; 0.05). The study group showed higher score in Spotter than the control group after treatment (P &lt; 0.05).DiscussionThis is the most extensive blinded, randomized clinical study to date examining the efficacy of 10-Hz add-on rTMS for first-onset adolescent depression. Our results support that add-on rTMS accelerates the efficacy of the antidepressants, improving the depressive symptoms and cold cognitive function in first-episode adolescent depression.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [ChiCTR2100048534].
Nurses experience of caring for patients with COVID-19: A phenomenological study
Authors: Al-amer Rasmieh , Darwish Maram , Malak Malakeh , Ali Amira Mohammed , Al weldat Kadejeh , Alkhamees Abdulmajeed , Alshammari Khaled S. , Abuzied Yacoub , Randall Sue 
Published: July 2022

IntroductionCOVID-19 has impacted all dimensions of life and imposed serious threat on humankind.BackgroundIn Jordan, understanding how nurses experienced providing care for patients with COVID-19 offers a framework of knowledge about similar situations within the context of Arabic culture.AimTo explore nurses' experience with providing hands-on care to patients with active COVID-19 infection in an Arabic society.MethodsA descriptive phenomenological study interviewed 10 nurses through a purposive sampling approach until data saturation was reached. The research site was hospital designated to receive patients with active COVID-19 infection. Semi-structured interviews were used to collect the data.FindingsThree themes were generated from the data: the impact of the COVID-19 outbreak on nurses' health; unfamiliar work and social environments; and conforming to professional standards.DiscussionThere are specific risks to the physical and mental wellbeing of nurses who provide hands-on care to patients with COVID-19 in an Arabic society.Implication for nursing and health policyHealth care institutions should consider establishing programs that promote nurses' wellbeing and support their productivity in a crisis. A danger pay allowance should be considered for nurses during extraordinary circumstances, such as pandemics.
Prevalence of Post-traumatic Stress Disorder Status Among Healthcare Workers and Its Impact on Their Mental Health During the Crisis of COVID-19: A Cross-Sectional Study
Authors: Yang Yue , Liu Di , Liu Bingshuo , Ou Weiyan , Wang Licheng , Ma Yuanshuo , Fan Lihua , Shi Yu , Shi Lei 
Published: July 2022

ObjectiveAfter the unprecedented coronavirus disease 2019 (COVID-19) outbreak, the health status of the general population has suffered a huge threat, and the mental health of front-line healthcare providers has also encountered great challenges. Therefore, this study aims to: (1) investigate the prevalence and influencing factors of post-traumatic stress disorder (PTSD) among healthcare providers, and (2) verify the moderating role of self-efficacy in the influence of PTSD on mental health.MethodsA cross-sectional study was conducted using an online survey of 1993 participants. The presence of depression, anxiety, self-efficacy, and PTSD was evaluated using screening tests from March 1. Sociodemographic and COVID-19-related data were also collected. A data analysis was performed using descriptive statistics, Pearson's correlation coefficient, and multiple linear regression.ResultsThe prevalence of PTSD among healthcare providers was 9.3%. PTSD was negatively correlated with self-efficacy (r = −0.265, P &lt; 0.01), anxiety (r = −0.453, P &lt; 0.01), and depression (r = 0.708, P &lt; 0.01). Profession, daily working hours, maximum continuous working days, and daily sleep time were influencing factors of PTSD. A binary logistic regression analysis showed that physicians (OR = 2.254, 95% CI = 1.298, 3.914) and nurses (OR = 2.176, 95% CI = 1.337, 3.541) were more likely to experience PTSD than other healthcare providers.ConclusionSelf-efficacy has a moderating effect on the influence of PTSD on anxiety and depression. This suggests that health managers need to respond to the current psychological crisis of healthcare providers, implement appropriate psychological interventions, and minimize the psychological harm caused by COVID-19.
Global Experiences of Community Responses to COVID-19: A Systematic Literature Review
Authors: Wu Yijin , Zhang Quan , Li Meiyu , Mao Qingduo , Li Linzi 
Published: July 2022

ObjectiveThis study aimed to conduct a systematic review of the global experiences of community responses to the COVID-19 epidemic.MethodFive electronic databases (PubMed, Embase, CINAHL, ScienceDirect, and Web of Science) were searched for peer-reviewed articles published in English, from inception to October 10, 2021. Two reviewers independently reviewed titles, abstracts, and full texts. A systematic review (with a scientific strategy for literature search and selection in the electronic databases applied to data collection) was used to investigate the experiences of community responses to the COVID-19 pandemic.ResultsThis review reported that community responses to COVID-19 consisted mainly of five ways. On the one hand, community-based screening and testing for Coronavirus was performed; on the other hand, the possible sources of transmission in communities were identified and cut off. In addition, communities provided medical aid for patients with mild cases of COVID-19. Moreover, social support for community residents, including material and psychosocial support, was provided to balance epidemic control and prevention and its impact on residents' lives. Last and most importantly, special care was provided to vulnerable residents during the epidemic.ConclusionThis study systematically reviewed how communities to respond to COVID-19. The findings presented some practical and useful tips for communities still overwhelmed by COVID-19 to deal with the epidemic. Also, some community-based practices reported in this review could provide valuable experiences for community responses to future epidemics.
Affective Image Sequence Viewing in Virtual Reality Theater Environment: Frontal Alpha Asymmetry Responses From Mobile EEG
Authors: Krogmeier Claudia , Coventry Brandon S , Mousas Christos 
Published: July 2022

Background: Numerous studies have investigated emotion in virtual reality (VR) experiences using self-reported data in order to understand valence and arousal dimensions of emotion. Objective physiological data concerning valence and arousal has been less explored. Electroencephalography (EEG) can be used to examine correlates of emotional responses such as valence and arousal in virtual reality environments. Used across varying fields of research, images are able to elicit a range of affective responses from viewers. In this study, we display image sequences with annotated valence and arousal values on a screen within a virtual reality theater environment. Understanding how brain activity responses are related to affective stimuli with known valence and arousal ratings may contribute to a better understanding of affective processing in virtual reality.Methods: We investigated frontal alpha asymmetry (FAA) responses to image sequences previously annotated with valence and arousal ratings. Twenty-four participants viewed image sequences in VR with known valence and arousal values while their brain activity was recorded. Participants wore the Oculus Quest VR headset and viewed image sequences while immersed in a virtual reality theater environment.Results: Image sequences with higher valence ratings elicited greater FAA scores than image sequences with lower valence ratings (F [1, 23] = 4.631, p = 0.042), while image sequences with higher arousal scores elicited lower FAA scores than image sequences with low arousal (F [1, 23] = 7.143, p = 0.014). The effect of valence on alpha power did not reach statistical significance (F [1, 23] = 4.170, p = 0.053). We determined that only the high valence, low arousal image sequence elicited FAA which was significantly higher than FAA recorded during baseline (t [23] = −3.166, p = 0.002), suggesting that this image sequence was the most salient for participants.Conclusion: Image sequences with higher valence, and lower arousal may lead to greater FAA responses in VR experiences. While findings suggest that FAA data may be useful in understanding associations between valence and arousal self-reported data and brain activity responses elicited from affective experiences in VR environments, additional research concerning individual differences in affective processing may be informative for the development of affective VR scenarios.
Barriers to Accessing Video-Based Telehealth Appointments at a Community Veterinary Clinic During the COVID-19 Pandemic
Authors: Naimark Alena M. , Elwood Stella E. , McCobb Emily , Kragen Benjamin , King Erin K. , Wolfus Greg 
Published: July 2022

ObjectiveTo assess veterinary needs of clients with low socioeconomic status during the COVID-19 pandemic, to explore the impact of the pandemic on marginalized communities, and to understand perceptions regarding barriers and incentives of telehealth appointments as a method to increase care access.Sample205 active Community Veterinary Medicine Clinic clients at Tufts at Tech Community Veterinary Clinic in Worcester, MA.ProceduresThis cross-sectional study used a survey-based method to assess veterinary needs of clients with low socioeconomic status during the COVID-19 pandemic. The survey measured client perceptions regarding potential barriers and incentives of telehealth appointments. Participants were randomly sampled from a list of active clients and completed the survey either by email or over the phone. The survey was available in both English and Spanish. Clients who completed the questionnaire received credit for a free examination.ResultsA total of 205 clients submitted survey responses. Factors affecting access to veterinary care were impacted by the COVID-19 pandemic. Access to reliable internet in the home was reported by 87% (n = 177) of participants. Digital access was correlated with education when controlling for race, income, age, and gender. Education was predictive of comfort with using video-chat (χ2 = 65, df = 24, p ≤ 0.01) and of whether or not clients reported need for assistance for using video-chat (χ2 = 52, df = 18, p ≤ 0.01). Patient education level was significantly predictive of wanting to use telehealth for at least one type of appointment (p ≤ 0.05).Conclusions and Clinical RelevanceThe findings indicate that implementing telehealth services at this Community Medicine Clinic is feasible for much of the active clientele and offers a new avenue to provide veterinary care during times of social distancing restrictions and beyond.