bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of circulating monocyte number and monocyte–lymphocyte ratio with cardiovascular disease in patients with bipolar disorder
Authors: Chen Pao-Huan , Chang Chi-Kang , Lin Yen-Kuang , Chiang Shuo-Ju , Trang Nguyen Ngoc 
Published: October 2024

Abstract
Background
Cardiovascular disease (CVD) is the leading cause of excessive and premature mortality in patients with bipolar disorder (BD). Despite immune cells participating considerably in the pathogenesis of CVD, limited data are available regarding leukocyte phenotypes in patients with BD and CVD. This study aimed to evaluate associations between circulating leukocyte subset and CVD among patients with BD.

Methods
A total of 109 patients with BD-I and cardiologist-confirmed CVD diagnosis (i.e., case) were matched with 109 BD-I patients without CVD (i.e., control) according to the age (± 2 years), sex, and date of most recent psychiatric admission because of acute mood episode (± 2 years). Leukocyte subset data were retrieved from complete blood count tests performed on the next morning after the most recent acute psychiatric admission.

Results
During the most recent acute psychiatric hospitalization, circulating monocyte counts in the case group were significantly higher than those in the age- and sex-matched controls (p = 0.020). In addition, monocyte–lymphocyte ratios (MLRs) in the case group were significantly higher than those in the control group (p = 0.032). Multiple logistic regression showed that together with serum levels of uric acid and manic symptoms, circulating monocyte counts (95% CI, OR: 1.01–1.05) and MLRs (95% CI, OR: 1.01–1.09) were significantly associated with CVD in patients with BD, respectively.

Conclusions
Monocyte activation in an acute manic episode may play a critical role in the pathogenesis of CVD among patients with BD. Future research is required to investigate markers of monocyte activation and indices of cardiovascular structure and function across the different mood states of BD.
Global, regional, and national impact of air pollution on stroke burden: changing landscape from 1990 to 2021
Authors: Fan Yu-xiang , Zhang Wen , Li Wei , Ma Yong-jie , Zhang Hong-qi 
Published: October 2024

Abstract
Background
Exposure to air pollution contributes to cardiovascular disease-related deaths and morbidity, including stroke. However, few studies have examined the global stroke burden linked to air pollution. This study aimed to evaluate the global stroke morbidity and mortality associated with air pollution from 1990 to 2021.

Method
With the Global Burden of Disease Study (GBD) 2021, the numbers, and age-standardized rates (ASRs) of deaths and disability-adjusted life years (DALYs) for air pollution-related stroke were reported globally. Further subgroup analyses were conducted by age, sex, region and country, and stroke subtypes. A linear regression model explored global temporal trends and a cluster analysis examined temporal trends across GBD regions. To predict trends until 2040, the age-period-cohort (APC) model and the Bayesian age-period-cohort (BAPC) model were applied.

Results
In 2021, there were 1,989,686 (95% uncertainty interval [95% UI], 1,530,479-2,493,238) deaths and 44,962,167 (95% UI, 35,020,339 − 55,467,024) DALYs due to air pollution-related stroke. The ASRs increased with age, peaking generally over 85 years. Males, the Central African region, and Guinea-Bissau showed higher stroke burdens Intracerebral hemorrhage was the most lethal subtype, with an ASR of 11.69 (95% UI 8.94–14.69) for deaths and 276.93 (95% UI 212.21-344.36) for DALYs. From 1990 to 2021, the crude number of deaths and DALYs increased by 13.4% and 6.3%, respectively, for the global stroke burden but showed a declining trend when age-standardized. Most GBD regions in Asia and Africa experienced an increasing stroke burden linked to air pollution, while Europe and America showed a decreasing trend. Predictions indicated a gradual reduction in ASRs, with higher rates in males from 2020 to 2040.

Conclusions
The global stroke burden associated with air pollution remained significant despite a decreasing trend until 2021. Although future predictions suggested a reduction, the crude counts for stroke burden remained substantial, with significant regional disparities. This warranted the implementation of public health policies and ongoing efforts.
Effect of authentic leadership on work readiness: the mediating role of nurses’ agility
Authors: Tawfik Ahmed Farghaly , Mahgoub Shimaa Abd El-fattah 
Published: October 2024

Abstract
Background
The dynamic and demanding nature of healthcare environments necessitates that nurses not only possess clinical proficiency but also exhibit high levels of work readiness to adapt swiftly to changes. Authentic leadership has been recognized as a critical factor influencing various organizational outcomes.

Aim
Investigating the mediating role of nurses’ agility in the relation between authentic leadership and nurses’ work readiness.

Design and method
A correlational analytical research design was utilized following STROBE guidelines, and data were collected from 249 nurses at a hospital affiliated with Beni-Suef University, Egypt. Instruments included authentic leadership Questionnaire, work readiness scale, and workforce agility scale. Data was collected from the beginning of March to the end of April 2024.

Results
The findings indicate that authentic leadership was notably strong regarding morality/ethics dimension (mean score: 15.81), and nurses demonstrated relatively high agility levels, particularly in proactivity (mean score: 29.16). Organizational acumen scored highest in work readiness dimensions (mean score: 53.94). Nurses’ overall scores for study variables ranged from 72 to 80% of the maximum, with agility scoring highest (mean score: 85.77). Significant positive correlations were found between variables, especially between nurses’ agility and authentic leadership (r = 0.362).

Conclusion
Path analysis reveals nurses’ agility as a paramount mediator between authentic leadership and nurses’ work readiness, indicating its vital role in transmitting the positive effects of authentic leadership. Practical implications include establishing authentic leadership programs that foster nurses’ agility especially proactive behaviors. That in turn improve nurses’ readiness for various work responsibilities.
Barriers and facilitators to women’s access to sexual and reproductive health services in rural Australia: a systematic review
Authors: Wood Sarah M , Alston Laura , Chapman Anna , Lenehan Jacinta , Versace Vincent L 
Published: October 2024

Abstract
Background
Accessing sexual and reproductive health (SRH) services in rural Australia presents complex challenges that negatively impact women’s health and exacerbate health inequities across the life course. This systematic review synthesises evidence on the barriers and facilitators to women’s access to SRH services in rural Australia, considering both supply and demand dimensions.

Methods
We systematically searched peer-reviewed literature published between 2013 and 2023. Search terms were derived from three major topics: (1) women living in rural Australia; (2) spatial or aspatial access to SRH services; and (3) barriers or facilitators. We adopted the “best fit” approach to framework synthesis using the patient-centred access to healthcare model.

Results
Database searches retrieved 1,024 unique records, with 50 studies meeting the inclusion criteria. Most studies analysed access to primary care services (n = 29; 58%), followed by hospital services (n = 14; 28%), health promotion and prevention (n = 5; 10%), and specialist care (n = 2; 4%). The type of care accessed was mostly maternity care (n = 21; 42%), followed by abortion services (n = 11; 22%), screening and testing (n = 8; 16%), other women’s health services (n = 6; 12%), and family planning (n = 4; 8%). There were numerous barriers and facilitators in access from supply and demand dimensions. Supply barriers included fragmented healthcare pathways, negative provider attitudes, limited availability of services and providers, and high costs. Demand barriers encompassed limited awareness, travel challenges, and financial burdens. Supply facilitators included health system improvements, inclusive practices, enhanced local services, and patient-centred care. Demand facilitators involved knowledge and awareness, care preferences, and telehealth accessibility.

Conclusion
This review highlights the urgent need for targeted interventions to address SRH service access disparities in rural Australia. Understanding the barriers and facilitators women face in accessing SRH services within the rural context is necessary to develop comprehensive healthcare policies and interventions informed by a nuanced understanding of rural women’s diverse needs.
Uncovering perspectives on physical activity in nursing homes: a qualitative exploration of the experiences of healthcare professionals and family caregivers
Authors: Trollebø Stine Øverengen , Taraldsen Kristin , Heiland Jonas Saur , Hawley-Hague Helen , Bardal Ellen Marie , Skjaeret-Maroni Nina 
Published: October 2024

Abstract
Background
The ageing population has increased the demand for healthcare services. In Norway, community-based long-term care are prioritised, leading to fewer nursing home places. As a result, nursing home residents are now older and have more complex needs. Nearly 92% of nursing home residents are affected by cognitive impairments accompanied by neuropsychiatric symptoms (NPS) that affect their daily activity, physical function, cognition, and behaviour. Traditionally, pharmacological therapy has been the prevailing treatment for NPS. However, emerging evidence suggests that physical activity can serve as an alternative treatment approach. Physical activity has the potential to maintain physical independence and enhance the quality of life (QoL) for the residents. Despite these benefits, institutionalisation in a nursing home often restricts activity levels of residents. This study explores facilitators and barriers to physical activity in nursing homes through the experiences of healthcare professionals and family caregivers. The goal is to enhance our understanding of how to promote and support physical activity for nursing home residents by identifying essential factors for successfully implementing daily physical activity initiatives.

Methods
Seven focus groups were conducted with a total of 31 participants. Participants included healthcare professionals (physiotherapists, nurses, unit- and department managers, assistant occupational therapists, and assistant nurses) and family caregivers of residents at nursing homes. Data were analysed using Braun and Clarke’s reflexive thematic analysis, underpinned by hermeneutic phenomenology.

Results
Three main themes related to facilitators and barriers to physical activity in nursing homes were identified: inconsistency in task prioritisation; need for improved interprofessional collaboration; and need for improved utilisation of external resources. The participants experienced task prioritisation and lack of interdisciplinary collaboration as barriers to physical activity. The involvement of external societal resources was considered as both a facilitator and a necessity for obtaining physical activity in nursing homes.

Conclusions
This study highlights the need for a consensus in task prioritisation, enhanced competence among healthcare professionals, and better interdisciplinary collaboration to facilitate physical activity in nursing homes. Involving external societal resources could be a strategic approach to address barriers and support physical activity initiatives. Future research should focus on developing effective strategies for interdisciplinary collaboration that prioritises and promotes physical activity in nursing homes.
Representation of multimorbidity and frailty in the development and validation of kidney failure prognostic prediction models: a systematic review
Authors: Walker Heather , Day Scott , Grant Christopher H. , Jones Catrin , Ker Robert , Sullivan Michael K. , Jani Bhautesh Dinesh , Gallacher Katie , Mark Patrick B. 
Published: October 2024

Abstract
Background

Prognostic models that identify individuals with chronic kidney disease (CKD) at greatest risk of developing kidney failure help clinicians to make decisions and deliver precision medicine. It is recognised that people with CKD usually have multiple long-term health conditions (multimorbidity) and often experience frailty. We undertook a systematic review to evaluate the representation and consideration of multimorbidity and frailty within CKD cohorts used to develop and/or validate prognostic models assessing the risk of kidney failure.

Methods
We identified studies that described derivation, validation or update of kidney failure prognostic models in MEDLINE, CINAHL Plus and the Cochrane Library—CENTRAL. The primary outcome was representation of multimorbidity or frailty. The secondary outcome was predictive accuracy of identified models in relation to presence of multimorbidity or frailty.

Results
Ninety-seven studies reporting 121 different kidney failure prognostic models were identified. Two studies reported prevalence of multimorbidity and a single study reported prevalence of frailty. The rates of specific comorbidities were reported in a greater proportion of studies: 67.0% reported baseline data on diabetes, 54.6% reported hypertension and 39.2% reported cardiovascular disease. No studies included frailty in model development, and only one study considered multimorbidity as a predictor variable. No studies assessed model performance in populations in relation to multimorbidity. A single study assessed associations between frailty and the risks of kidney failure and death.

Conclusions
There is a paucity of kidney failure risk prediction models that consider the impact of multimorbidity and/or frailty, resulting in a lack of clear evidence-based practice for multimorbid or frail individuals. These knowledge gaps should be explored to help clinicians know whether these models can be used for CKD patients who experience multimorbidity and/or frailty.

Systematic review registration
This review has been registered on PROSPERO (CRD42022347295).
iPSC-derived blood-brain barrier modeling reveals APOE isoform-dependent interactions with amyloid beta
Authors: Ding Yunfeng , Palecek Sean P. , Shusta Eric V. 
Published: October 2024

Abstract
Background
Three common isoforms of the apolipoprotein E (APOE) gene - APOE2, APOE3, and APOE4 - hold varying significance in Alzheimer’s Disease (AD) risk. The APOE4 allele is the strongest known genetic risk factor for late-onset Alzheimer’s Disease (AD), and its expression has been shown to correlate with increased central nervous system (CNS) amyloid deposition and accelerated neurodegeneration. Conversely, APOE2 is associated with reduced AD risk and lower CNS amyloid burden. Recent clinical data have suggested that increased blood-brain barrier (BBB) leakage is commonly observed among AD patients and APOE4 carriers. However, it remains unclear how different APOE isoforms may impact AD-related pathologies at the BBB.

Methods
To explore potential impacts of APOE genotypes on BBB properties and BBB interactions with amyloid beta, we differentiated isogenic human induced pluripotent stem cell (iPSC) lines with different APOE genotypes into both brain microvascular endothelial cell-like cells (BMEC-like cells) and brain pericyte-like cells. We then compared the effect of different APOE isoforms on BBB-related and AD-related phenotypes. Statistical significance was determined via ANOVA with Tukey’s post hoc testing as appropriate.

Results
Isogenic BMEC-like cells with different APOE genotypes had similar trans-endothelial electrical resistance, tight junction integrity and efflux transporter gene expression. However, recombinant APOE4 protein significantly impeded the “brain-to-blood” amyloid beta 1–40 (Aβ40) transport capabilities of BMEC-like cells, suggesting a role in diminished amyloid clearance. Conversely, APOE2 increased amyloid beta 1–42 (Aβ42) transport in the model. Furthermore, we demonstrated that APOE-mediated amyloid transport by BMEC-like cells is dependent on LRP1 and p-glycoprotein pathways, mirroring in vivo findings. Pericyte-like cells exhibited similar APOE secretion levels across genotypes, yet APOE4 pericyte-like cells showed heightened extracellular amyloid deposition, while APOE2 pericyte-like cells displayed the least amyloid deposition, an observation in line with vascular pathologies in AD patients.

Conclusions
While APOE genotype did not directly impact general BMEC or pericyte properties, APOE4 exacerbated amyloid clearance and deposition at the model BBB. Conversely, APOE2 demonstrated a potentially protective role by increasing amyloid transport and decreasing deposition. Our findings highlight that iPSC-derived BBB models can potentially capture amyloid pathologies at the BBB, motivating further development of such in vitro models in AD modeling and drug development.
Three-month outcomes and cost-effectiveness of interferon gamma-1b in critically ill patients: a secondary analysis of the PREV-HAP trial
Authors: Bouras Marwan , Tessier Philippe , Poulain Cécile , Schirr-Bonnans Solène , Roquilly Antoine 
Published: October 2024

Abstract
Background
Interferon gamma‑1b has been proposed to treat critical illness-induced immunosuppression. We aimed to determine the effects on 90-day outcomes and the cost-effectiveness of interferon gamma‑1b compared to placebo in mechanically ventilated critically ill patients.

Methods
A cost-effectiveness analysis (CEA) was embedded in the “PREV-HAP trial”, a multicenter, placebo‑controlled, randomized trial, which randomly assigned critically ill adults under mechanical ventilation to receive interferon gamma or placebo. The CEA compared interferon-gamma with placebo using a collective perspective at a 90-day time horizon. The primary outcome was the incremental cost-effectiveness ratio (ICER) expressed in terms of adjusted cost per adjusted Quality-Adjusted Life-Years (QALYs) gained. QALYs were estimated from the responses of patients and proxy respondents to the health-related quality of life questionnaire EQ-5D-3L.

Results
The 109 patients in the PREV-HAP trial were included in the CEA. At day 90, all-cause mortality rates were 23.6% in the interferon group and 25% in the placebo group (Odds Ratio (OR) = 0.88 (0.40 –1.93) p = 0.67). The difference in the mean adjusted costs per patient at 90 days was €-1.638 (95%CI €-17.534 to €11.968) in favor of interferon gamma-1b. The mean difference in adjusted QALYs between interferon gamma-1b and the placebo group was + 0.019 (95%CI -0.005 to 0.043). The probability that interferon gamma-1b was cost-effective ranged from 0.60 to 0.71 for a willingness to pay a QALY between €20k and €150k for the base case analysis.

Conclusion
Early administration of interferon gamma might be cost-effective in critically ill patients supporting the realization of other studies on this treatment. However, the generalization of the findings should be considered cautiously, given the small sample size due to the premature end of PREV-HAP.
Trial registration ClinicalTrials.gov Identifier: NCT04793568, Registration date: 2021–02-24.
A literature review on the integration of microlearning and social media
Authors: Denojean-Mairet Marc , López-Pernas Sonsoles , Agbo Friday Joseph , Tedre Matti 
Published: October 2024

AbstractThe study aimed to perform a literature review to identify the trends, impacts, and challenges associated with the integration of microlearning and social media. A total of seven academic databases were used as sources for searching: Scopus, Web of Science, ACM, EBSCOhost, PubMed, ProQuest, and IEEE. A combination of keywords related to microlearning and social media was employed during the search process. No specific date limit was imposed, but only materials published in English were considered for inclusion. A total of 2312 articles were identified in the first phase of the search. Sixteen articles were selected during phase two after applying the inclusion and exclusion criteria. The reviewed studies encompassed various fields, including computing, programming, language, nursing, surgery, and radiology. Additionally, multiple social media platforms were identified, such as podcasts, chatbots, Facebook, Instagram, LinkedIn, MP3, TikTok, Twitter, YouTube, and Sina Weibo. The results indicate that the integration of microlearning and social media has the potential to enhance learning outcomes positively. These outcomes include increased learner satisfaction, expanded reach, improved learner engagement, and enhanced learning effectiveness. Additionally, the review highlights that the most significant benefits of combining microlearning with social media are increased reach and enhanced learner engagement.
Interactions between cancer and stroma mediated by extracellular vesicles
Authors: Najafzadeh Mahsa , Sajjadi Seyed Mehdi , Kharazi Sam , Karimifard Farzaneh , Safarpour Hossein , Kharazinejad Ebrahim 
Published: October 2024

AbstractExtracellular vehicles (EVs) are small membrane-bound particles that are released by both cancer and stromal cells. These vesicles have emerged as key mediators of intercellular communication within the tumor microenvironment. In particular, EVs have been shown to play a critical role in facilitating the interactions between cancer cells and the surrounding stroma. Through the transfer of various bioactive molecules, including proteins, lipids, and nucleic acids, EVs are able to modulate the behavior of recipient cells and promote tumorigenesis. Additionally, EVs can also contribute to the development of drug resistance and immune evasion, further highlighting their importance in cancer progression. This review will summarize the current knowledge regarding EV-mediated interactions between cancer and stromal cells, and discuss their implications for cancer diagnosis and therapy.