bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safeguarding Lungs: Evaluating Pneumocystis Pneumonia Prophylaxis in Lymphoma Patients Receiving Rituximab-Inclusive Therapies
Authors: Sharma Anubhuti , Sharma Arundhati , Daid Simranpreet Singh , Sharma Vagisha , Agrawal Akriti , Rao Adishwar , Poulose Joyson 
Published: December 2024

Background: Pneumocystis pneumonia (PCP) is an opportunistic fungal infection, which is frequently observed in immunocompromised patients. Although T-cell immunity is classically related to Pneumocystis defense, recent data support roles for B lymphocytes in the development of PCP in animals, and we have observed several cases of PCP in patients receiving rituximab. These observations prompted a systematic review and meta-analysis of our experience to see the efficacy of PCP prophylaxis (TMP-SMX) in lymphoma patients receiving rituximab. The efficacy of PCP prophylaxis in this population remains a subject of clinical interest.
Research Question: To evaluate the effect of PCP prophylaxis compared to no prophylaxis on the risk of developing PCP in lymphoma patients receiving rituximab.
Methods: We conducted meta-analysis including six retrospective cohort studies that compared the incidence of PCP in lymphoma patients receiving rituximab with and without prophylaxis. The cohort studies with incept up to January 2023 were retrieved from databases including PubMed, Google Scholar, EMBASE, PLOS ONE, Cochrane, and ClinicalTrials.gov. Data extraction was done using a spreadsheet, and data analysis was done using RevMan 5.4.1 for meta-analysis.
Results: The analysis included 2304 patients, with 571 receiving PCP prophylaxis and 1733 did not receive prophylaxis. Studies reporting results of PCP prophylaxis were included. Enrolled studies were quality assessed with Newcastle-Ottawa Scale. The incidence of PCP was significantly lower in the prophylaxis group (3 out of 571) compared to the no prophylaxis group (67 out of 1733). The pooled risk ratio (RR) was 0.23 [95% CI, 0.09 to 0.58], indicating a 77% reduction in the risk of PCP with prophylaxis.
Conclusion: The clinical course of cases of PCP in patients treated with rituximab can be quite fulminant, with significant mortality. Primary prophylaxis should be considered in patients at risk. PCP prophylaxis significantly decrease the risk of PCP in lymphoma patients receiving rituximab-based therapies, with a pooled risk ratio of 0.23.
Risk Determination in Pediatric Patients for Venous Thromboembolism
Authors: Loi Kyle , Brown Craig , Fan Qiyin , Kronfield Charlotte , McGrath Mary , Obi Andrea 
Published: December 2024

Objective: Cases of hospital-acquired acute deep venous thrombosis (HA-DVT) and pulmonary embolism (HA-PE) within the pediatric population are rare. Risk assessment models (RAMs) are used to identify a patient's likelihood of developing venous thromboembolism (VTE). When VTE risk exceeds bleeding risk of low dose anticoagulants, patients are prescribed thromboprophylaxis. Within this study, we aim to highlight previously identified risk factors for pediatric HA-VTE by comparing three different RAMs: Caprini, Children's Hospital-Acquired Thrombosis (CHAT) Consortium Admission, and the Peds-Clot clinical Decision Rule (PCDR).
Methods: This retrospective case-control study focused on pediatric patients between the ages of 12 and 22 admitted to a single institution from 2017 to 2022. Cases of acute VTE (defined as HA-DVT and/or PE) were matched to randomly selected controls 2:1 matched on length of stay. Total scores for Caprini, CHAT, and PCDR RAMs were calculated using clinical data extracted from chart review. Cases and controls were compared using chi2 and Mann-Whitney U test for categorical and continuous outcomes, respectively.
Results: The total incidence of acute VTE amongst adolescent and young adult inpatients was 0.2% (33/16,186). Cases were found to have a significantly higher BMI compared to controls (38.8±7.9 vs 22.4±6.2, p&lt;0.001). No difference in age was found for cases compared to controls (mean age 17.2±2.2 vs 16.3±2.4, p=0.64). The PCDR scores were slightly different between cases and controls (2.32 vs 1.24, p=0.001) as were the modified Caprini scores (6.5 vs 2, p&lt;0.001) whereas the CHAT predicted probability demonstrated a near ten-fold enrichment in risk amongst cases compared to controls (9.3% v. 0.8%, p=0.02). The risk factor determined to be significant across all RAM was the placement of a central venous catheter.
Conclusions: Cases for our study had an extremely low incidence rate, underscoring the importance of a robust risk assessment model capable of defining a high-risk population. Even amongst the highest risk population, (those who developed acute HA-VTE), the average calculated risk in the best-performing RAM was only found to be 9.3%. Currently available pediatric VTE RAMs may lead to overuse of thromboprophylaxis when broadly applied.
Exploring the Intersectionality of Marital Status and Sex on Survival Outcomes in Non-Hodgkin's Lymphoma
Authors: Akinyemi Oluwasegun Austine , Abobarin-Aofolaju Olufunmilayo , Abodunrin Faith , Adeoye Tayo , Adubi Oreoluwa , Fasokun Mojisola , Ikugbayigbe Seun , Odusanya Eunice , Michael Miriam , Hughes Kakra 
Published: December 2024

INTRODUCTION: Non-Hodgkin's Lymphoma (NHL) survival is influenced by various factors, including marital status and sex. This study explores how these intersecting factors affect cancer-specific (CSS) and overall survival (OS) in NHL patients.
OBJECTIVE: To examine the intersection of sex and marital status on survival outcomes among individuals with NHL.
METHODOLOGY: We conducted a retrospective cohort study using SEER registry data for individuals aged 18-85 diagnosed with NHL. Cox regression models assessed the influence of marital status and sex on CSS and overall survival OS, adjusting for age, race, household income, disease stage, primary site, and treatment (chemotherapy, radiotherapy, surgery). Kaplan-Meier curves and log-rank tests compared survival distributions.
RESULT: The study analyzed 319,013 individuals with NHL from 2000 to 2020. Participants were predominantly white (73.0%) and female (54.7%), with 54.6% married and a median age of 66 years (IQR 55-76). Females exhibited a 33% higher hazard of death for cancer-specific survival (HR = 1.34, 95% CI: 1.30-1.38) and a 40% higher hazard for overall survival (HR = 1.40, 95% CI: 1.37-1.44). The interaction of marital status and sex significantly impacts both CSS and OS among individuals with NHL. Widowed individuals, regardless of sex, showed the highest risk of death; males had a cancer-specific hazard ratio (HR) of 2.50 (95% CI: 2.35-2.65) and overall HR of 2.31 (95% CI: 2.21-2.41), while females had a cancer-specific HR of 3.09 (95% CI: 2.87-3.31) and overall HR of 2.97 (95% CI: 2.82-3.12). Divorced and separated individuals also exhibited elevated risk. Notably, married males had the lowest hazard ratios, with cancer-specific HR of 1.07 (95% CI: 1.03-1.12) and overall HR of 0.87 (95% CI: 0.84-0.89).
CONCLUSION: This study highlights that marital status and sex significantly influence survival outcomes in NHL patients. Widowed individuals have the highest mortality risk, while being married is associated with better survival, especially for males. These findings emphasize the role of social support and gender-specific factors in NHL prognosis.
Disparity in Access to Myeloma CAR-T: A Geospatial Analysis of Distance to CAR-T Centers and Its Impact on Mortality
Authors: Daunov Michael , Gorham Benjamin , Ignatz-Hoover James J 
Published: December 2024

Introduction
Novel therapy with chimeric antigen receptor T-cell therapy (CAR-T) has revolutionized treatment options for patients with multiple myeloma (MM). However, disparities in access persist. One such disparity is related to access to CAR-T services, limited to specialized academic centers nationwide. We aimed to examine the disparity in access based purely on geographic distance to the nearest CAR-T center in the lower United States.
Methods
MM age-adjusted mortality per 100,000 persons organized by county was obtained from the NCI Cancer Atlas for both sexes and all races. A list of CAR-T centers was obtained from ide-cel and cilta-cel websites. These data were uploaded as Geographic Information System (GIS) layers using QGIS software. Distance from each county with available mortality data to nearest CAR-T center was then calculated. A comparison of mortality and distance from CAR-T center was performed for both ide-cel and cilta-cel using simple linear regression and Pearson bivariate correlations. Statistics were calculated using SPSS software.
Results
Based on NCI data, 747 US Counties had available mortality data for patients with multiple myeloma; 156 had available data by race. A total of 76 ide-cel and 55 cilta-cel sites were identified. For ide-cel, distance was correlated to age-adjusted mortality per 100,000 persons (r=.093, p=.011) and regression suggested that distance to nearest ide-cel site accounted for 0.9% of age-adjusted mortality (F=6.42, p=.011). For cilta-cel, distance was correlated to age-adjusted mortality per 100,000 persons (r=.122, p&lt;.001) and regression suggested that distance to nearest cilta-cel site accounted for 1.5% of age-adjusted mortality (F=11.24, p&lt;.001). When assessing disparity by race, non-Hispanic Blacks had a more age-adjusted mortality due to distance from CAR-T Center. For ide-cel, distance accounted for 2.5% of non-Hispanic Black age-adjusted mortality (F=3.929, p=.049). For cilta-cel, distance accounted for 6.4% of non-Hispanic Black age-adjusted mortality (F=10.404, p=.002).
Conclusions
Using geospatial analysis, we identified that a county's distance to CAR-T center had a statistically significant impact on age-adjusted multiple myeloma mortality. This impact was more pronounced for Non-Hispanic Black patients, of particular interest as MM is more likely to affect the Black patient. As more patients become eligible for CAR-T therapy, the benefit of living near a CAR-T center will likely grow. Distance to CAR-T centers may form a new interface with a patient's social determinants of health, creating a new health care disparity in MM.
Attenuated processing of vowels in the left temporal cortex predicts speech-in-noise perception deficit in children with autism
Authors: Fadeev Kirill A. , Romero Reyes Ilacai V. , Goiaeva Dzerassa E. , Obukhova Tatiana S. , Ovsiannikova Tatiana M. , Prokofyev Andrey O. , Rytikova Anna M. , Novikov Artem Y. , Kozunov Vladimir V. , Stroganova Tatiana A. , Orekhova Elena V. 
Published: December 2024

Abstract
Background
Difficulties with speech-in-noise perception in autism spectrum disorders (ASD) may be associated with impaired analysis of speech sounds, such as vowels, which represent the fundamental phoneme constituents of human speech. Vowels elicit early (< 100 ms) sustained processing negativity (SPN) in the auditory cortex that reflects the detection of an acoustic pattern based on the presence of formant structure and/or periodic envelope information (f0) and its transformation into an auditory “object”.

Methods
We used magnetoencephalography (MEG) and individual brain models to investigate whether SPN is altered in children with ASD and whether this deficit is associated with impairment in their ability to perceive speech in the background of noise. MEG was recorded while boys with ASD and typically developing boys passively listened to sounds that differed in the presence/absence of f0 periodicity and formant structure. Word-in-noise perception was assessed in the separate psychoacoustic experiment using stationary and amplitude modulated noise with varying signal-to-noise ratio.

Results
SPN was present in both groups with similarly early onset. In children with ASD, SPN associated with processing formant structure was reduced predominantly in the cortical areas lateral to and medial to the primary auditory cortex, starting at ~ 150—200 ms after the stimulus onset. In the left hemisphere, this deficit correlated with impaired ability of children with ASD to recognize words in amplitude-modulated noise, but not in stationary noise.

Conclusions
These results suggest that perceptual grouping of vowel formants into phonemes is impaired in children with ASD and that, in the left hemisphere, this deficit contributes to their difficulties with speech perception in fluctuating background noise.
Evolutionary literacy as a catalyst for sustainable futures: connecting biological evolution education and education for sustainability
Authors: Pessoa Patrícia , Lopes J. Bernardino , de Lima Joelyn , Pinto Alexandre , Søgaard Jørgensen Peter , Sá-Pinto Xana 
Published: December 2024

AbstractIn the face of growing societal, public health and environmental challenges linked to the functioning of the biosphere, strong evolutionary literacy emerges as indispensable to plan and achieve sustainable futures. However, research on evolution education has mainly focused on the content taught in classrooms, leaving its application to sustainability issues largely unexplored. Given this, in this paper, we suggest an integrated view of biological evolution education and sustainability education. For that, we argue for the pivotal role of evolutionary literacy to address diverse sustainability issues and for the development of key competencies in sustainability, namely systems thinking and anticipatory competencies. To support the implementation in classrooms, we propose educational strategies to promote evolutionary literacy, systems thinking and anticipatory competencies through socioscientific issues linked to sustainability topics. Finally, we identify future research needed at the intersection of evolution education and education for sustainability to effectively promote evolutionary literacy and the development of key competencies in sustainability. With this, we aim to contribute to further enhancing education for sustainability through the lens of evolution.
Impact of DNA extraction, PCR amplification, sequencing, and bioinformatic analysis on food-associated mock communities using PacBio long-read amplicon sequencing
Authors: Baer Mareike , Höppe Lisa , Seel Waldemar , Lipski André 
Published: December 2024

Abstract
Background
Long-read 16S rRNA gene amplicon sequencing has a high potential for characterizing food-associated microbiomes. The advantage results from sequencing the full-length (1,500 bp) gene, enabling taxonomic resolution at species level. Here we present a benchmarking study using mock communities representative of milking machine biofilms and raw meat, revealing challenges relevant to food-associated habitats. These were varying species abundances, reliable intra-genus differentiation of species, and detection of novel species with < 98.7% sequence identity to type strains. By using mock communities at different levels of preparation − as mixed whole cells, mixed extracted DNA, and mixed PCR products − we systematically investigated the influence of DNA extraction using two different kits, PCR amplification of 16S rRNA genes, sequencing, and bioinformatics analysis including reference database and gene copy number normalization on bacterial composition and alpha diversity.

Results
We demonstrated that PacBio ccs-reads allowed for correct taxonomic assignment of all species present within the mock communities using a custom Refseq database. However, choice of percent identity values for taxonomic assignment had a strong influence on identification and processing of reads from novel species. PCR amplification of 16S rRNA genes produced the strongest bias on the observed community composition, while sequencing alone reproduced the preset composition well. The PCR bias can in part be attributed to differences in mol% G + C content of 16S rRNA genes resulting in preferred amplification of low mol% G + C-containing taxa.

Conclusions
This study underlines the importance of benchmarking studies with mock communities representing the habitat of interest to evaluate the methodology prior to analyzing real samples of unknown composition. It demonstrates the advantage of long-read sequencing over short-read sequencing, as species level identification enables in-depth characterization of the habitat. One benefit is improved risk assessment by enabling differentiation between pathogenic and apathogenic species of the same genus.
Effectiveness of non-pharmacological interventions in managing symptom clusters among lung cancer patients: a systematic review
Authors: Chen Qiuhong , Li Yonglin , Lin Yiyang , Lin Xiujing , Arbing Rachel , Chen Wei-Ti , Huang Feifei 
Published: December 2024

Abstract
Background
Non-pharmacological interventions, as complements to pharmacological treatments, are widely employed for managing symptom clusters in patients with lung cancer. Although numerous systematic reviews and meta-analyses have explored the effects of these interventions, most studies have centred on the broader cancer population and specific symptom clusters. This review aims to consolidate existing non-pharmacological interventions and assess their effectiveness in managing symptom clusters among lung cancer patients.

Methods
A comprehensive literature search, encompassing eight databases from inception to October 1, 2024, was conducted. Two independent reviewers carried out the study selection, quality assessment, and data extraction. Methodological quality was evaluated using the Cochrane Risk-of-Bias 2 tool and the Risk of Bias in Non-randomized Studies of Interventions. The findings were synthesized narratively based on intervention type and supplemented by meta-analysis using RevMan 5.4 software. The study protocol was registered with PROSPERO (CRD42023467406).

Results
This systematic review comprised 15 relevant studies involving 1,692 patients, published between 2011 and 2024. The analysis revealed the effectiveness of psychological, educational, and complementary or alternative medicine interventions in alleviating the severity of most symptom clusters. However, the efficacy of exercise-based and multimodal interventions remained inconclusive. The meta-analysis demonstrated a positive impact of non-pharmacological interventions on depression compared with the control conditions (SMD = -0.30, 95% CI [-0.46, -0.15], p < 0.01, I2 = 6%). Additionally, the educational intervention subgroup showed low heterogeneity and effectively improved fatigue (SMD = -0.50, 95% CI [-0.68, -0.33], p < 0.01, I2 = 0%).

Conclusions
Psychological and educational interventions have proven effective in managing symptom clusters in lung cancer patients. However, further research is needed to explore the effects of exercise, multimodal approaches, and complementary or alternative medicine. To enhance symptom management, future research could focus on core symptom clusters.
Challenges of modern work environments and means of overcoming them in the context of psychosocial risk assessments
Authors: Pavlista Valeria , Angerer Peter , Diebig Mathias 
Published: December 2024

Abstract
Background
Modern work environments constitute an underrepresented part of psychosocial risk assessments at work. Little is known about whether there is an increased stress load at all and what possible improvements could be made in such a case.

Methods
Modern work environments were assessed in an online questionnaire in 33 companies across a period of more than 4 years. A total of 3431 employees participated in the study. Both quantitative and qualitative data was applied to obtain a differentiated picture.

Results
Increased stress caused by modern work environments was an issue for around a third of the sample. 31.6% of the participants at least sometimes struggled to balance work and private life. Quite a few of the participants (36.3%) worked sometimes or more outside regular working hours. For 32.4% of participants, the workload has increased due to new technologies, but for 30.4% it has not. The majority (81.4%) feel they can work productively in home offices. The data from 178 completed free text fields on improving modern work environments from the employees’ perspective was analysed. Many named suggestions relate to improvements in time management.

Conclusion
This study provides both detailed insights into various aspects of modern work environments and offers solutions to counteract possible negative consequences. Assessing modern work environments in psychosocial risk assessments would be a valuable addition to its completeness.
Barriers and facilitators to effective pain management in elderly Arab patients: a nursing perspective through a qualitative study
Authors: Shaban Mostafa , Shaban Marwa Mamdouh , Mohammed Huda Hamdy , El-kest Hend Reda Ali 
Published: December 2024

Abstract
Background
Effective pain management in elderly patients is crucial for quality of life, yet cultural and institutional factors can significantly impact care delivery, particularly in Arab healthcare settings.

Aim
To explore the barriers and facilitators to effective pain management in elderly Arab patients from the perspective of nurses.

Methods
A qualitative descriptive study was conducted with 12 registered nurses from various departments at Tanta University Hospitals, Egypt. Data were collected through semi-structured interviews, observations, and document analysis. Content analysis was used to identify themes and subthemes.

Results
Five main themes emerged: (1) Cultural Barriers to Pain Expression, including stoicism and religious beliefs; (2) Institutional Barriers to Pain Management, such as resource limitations and time constraints; (3) Facilitators to Effective Pain Management, including family support and nurse adaptability; (4) Interdisciplinary Collaboration, emphasizing teamwork and education; and (5) Emotional and Professional Rewards for nurses. Cultural factors often led to underreporting of pain, while institutional constraints hindered thorough assessments. Nurse adaptability and family support, when present, facilitated better pain management.

Conclusion
The study reveals complex interplay between cultural, institutional, and professional factors influencing pain management in elderly Arab patients. Findings suggest the need for culturally sensitive pain assessment tools, enhanced nurse education in pain management, and policies promoting family-centered care and interdisciplinary collaboration.

Implications
Results can inform the development of culturally appropriate pain management strategies and policies in Arab healthcare settings, potentially improving care quality for elderly patients.