bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Diabetes Mellitus in Hospital Outcomes Among Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation: A NIS 2016 to 2020 Database Study
Authors: Neupane Niraj , Srivastava Arnav , Mahmoud Amir , Budhathoki Pravash , Shah Anish , Agrawal Shubham , Joshi Utsav , Kharel Himal , Sanjeevi Aditya , Dhakal Binod 
Published: December 2023

Impact of Diabetes Mellitus in Hospital Outcomes among Patients with Multiple Myeloma undergoing stem cell transplantation: A NIS 2016 to 2020 database Study.
Background.
Diabetes Mellitus (DM) is one of the comorbidities included in the Hematopoietic Cell Transplant-Specific Comorbidity Index (HCT-CI), which predicts the risk of non-relapse mortality (NRM) and overall mortality (OM) after transplantation. Therefore, they refrained from getting an Autologous stem cell transplant (ASCT) due to the concern of higher toxicity. However, limited data exist to assess this association. In this analysis, we intend to find the impact of DM on hospital outcomes in MM undergoing ASCT.
Methods:
A retrospective analysis of the NIS database was conducted using International Classification of Diseases (ICD-10) codes to identify hospitalization with ASCT for multiple myeloma and obesity with BMI &gt; 30 kg/m2. STATA version MP14.2 was used for analysis. We used Fischer's exact test to compare proportions, the student's t-test to compare continuous variables, and multivariate regression analysis to calculate the adjusted odds ratio after controlling age, gender, primary payer, and CCI. Transplant complication includes (transplant rejection, transplant failure, and transplant infection).
Results:
Among 31,390 hospitalizations, 5475 (17.44%) were Diabetic. The mean age to get ASCT was 63 vs. 61, P &lt; 0.001) with DM and without DM. Both groups had male predominance, with Caucasians being the most common race. The mean Charlson comorbidity index (CCI) in DM was 3 vs. 2.32 without DM. After Multivariate analysis, we found ICU admission (AOR: 0.28, 95% CI: 0.14-0.54, P &lt;0.001), length of hospital stay (16.53 vs. 16.79, P &lt;0.001) and acute kidney injury (AOR: 0.70, 95% CI: 0.56-0.87, P = 0.02) was significantly decreased with DM. However, there was no significant difference in the rate of blood transfusion (AOR: 0.87, 95% CI: 0.68-1.11, P = 0.87), transplant complication (AOR: 0.66, 95% CI: 0.42-1.01, P = 0.06), hospital mortality (AOR: 0.45, 95% CI: 0.19-1.03, P = 0.06). The only increase in the patient with DM was Mean hospital charges ($206,796.4 vs. $200,878.3, P = 0.013).
Conclusion:
This analysis shows that while some complications were decreased, blood transfusion rate and hospital mortality were not significantly affected. The study highlights the potential implications of DM in this patient population and warrants further investigation to individualize and optimize transplant outcomes.
Educating the Sickle Cell Team about the Social Work Role
Authors: Moorman Spencer , Johnson Shirley , Raj Ashok B. 
Published: December 2023

Background
Sickle cell disease, an often-painful lifelong inherited condition, is layered with acknowledged social determinants of health and systemic social inequities (Hassell, 2010). Psychological stress, depression, and anxiety can be linked with the disease's wrath along with financial hardship, limited healthcare access, racial discrimination, and cognitive and behavioral challenges. Although the need for quality psychosocial support exists for this vulnerable patient population, lack of understanding of the social work role was identified as a barrier to care, along with others, by National Alliance of Sickle Cell Centers (NASCC) social workers at the 2022 consortium conference. Like other disease realms (Bartlett et al., 2022) that have referenced physician lack of knowledge around the breadth of roles, capabilities, training and expertise, the social work scope of practice knowledge gap amongst providers was voiced as a clear barrier to efficient and effective patient care in the sickle cell realm as well. As a result, a subcommittee of NASCC social workers set out to provide an educational guide and breakdown of the social work profession, to help address this ever-present issue.
Methods
Five social workers gathered data of the various social work roles from other NASCC social work participants and online sources. Job descriptions from seven institutions were shared for the project and an itemized breakdown of education level, practicum training and experience, and licensure requirements were outlined.
Results
A detailed table of all tasks, course work, training, licensure, and scope of practice was created and displayed in a presentation for all NASCC in person providers. For each education tier (BSW, MSW, PhD), details of the associated requirements (training hours and course requirements), licensure (CSW, LCSW, LMSW, LBSW, etc.), focus (macro, mezzo, micro) and scope of practice (tasks involved) were displayed via both a table and visual illustration for other disciplines reference and awareness. NASCC medical providers shared their appreciation for the detailed breakdown of social work levels and expressed the need for this guide to educate other interdisciplinary team members and administrative staff alike.
Discussion
Many medical providers are unaware that the term social worker encapsulates varied levels of education, training, licensure, and scopes of practice. It is important for interdisciplinary team members to understand the integral social work role, its capabilities, breadth of skills, and specific responsibilities. Whether a case manager, transition coordinator, or licensed therapist or counselor, knowing the nuances and qualifications of each position under the social work umbrella can help to better inform care processes, referrals, and appropriate access to quality care.
Metabolite itaconate in host immunoregulation and defense
Authors: Yang Wenchang , Wang Yaxin , Tao Kaixiong , Li Ruidong 
Published: December 2023

AbstractMetabolic states greatly influence functioning and differentiation of immune cells. Regulating the metabolism of immune cells can effectively modulate the host immune response. Itaconate, an intermediate metabolite derived from the tricarboxylic acid (TCA) cycle of immune cells, is produced through the decarboxylation of cis-aconitate by cis-aconitate decarboxylase in the mitochondria. The gene encoding cis-aconitate decarboxylase is known as immune response gene 1 (IRG1). In response to external proinflammatory stimulation, macrophages exhibit high IRG1 expression. IRG1/itaconate inhibits succinate dehydrogenase activity, thus influencing the metabolic status of macrophages. Therefore, itaconate serves as a link between macrophage metabolism, oxidative stress, and immune response, ultimately regulating macrophage function. Studies have demonstrated that itaconate acts on various signaling pathways, including Keap1-nuclear factor E2-related factor 2-ARE pathways, ATF3–IκBζ axis, and the stimulator of interferon genes (STING) pathway to exert antiinflammatory and antioxidant effects. Furthermore, several studies have reported that itaconate affects cancer occurrence and development through diverse signaling pathways. In this paper, we provide a comprehensive review of the role IRG1/itaconate and its derivatives in the regulation of macrophage metabolism and functions. By furthering our understanding of itaconate, we intend to shed light on its potential for treating inflammatory diseases and offer new insights in this field.
Functional and kinetics of two efficient phenylalanine ammonia lyase from Pyrus bretschneideri
Authors: Li Guohui , Song Cheng , Manzoor Muhammad Aamir , Li Daoyuan , Cao Yunpeng , Cai Yongping 
Published: December 2023

Abstract
Background
The enzyme phenylalanine ammonia lyase (PAL) controls the transition from primary to secondary metabolism by converting L-phenylalanine (L-Phe) to cinnamic acid. However, the function of PAL in pear plants (Pyrus bretschneideri) has not yet been fully elucidated.

Results
We identified three PAL genes (PbPAL1, PbPAL2 and PbPAL3) from the pear genome by exploring pear genome databases. The evolutionary tree revealed that three PbPALs were classified into one group. We expressed PbPAL1 and PbPAL2 recombinant proteins, and the purified PbPAL1 and PbPAL2 proteins showed strict substrate specificity for L-Phe, no activity toward L-Tyr in vitro, and modest changes in kinetics and enzyme characteristics. Furthermore, overexpression of PbAL1 and PbPAL1-RNAi, respectively, and resulted in significant changes in stone cell and lignin contents in pear fruits. The results of yeast one-hybrid (Y1H) assays that PbWLIM1 could bind to the conserved PAL box in the PbPAL promoter and regulate the transcription level of PbPAL2.

Conclusions
Our findings not only showed PbPAL’s potential role in lignin biosynthesis but also laid the foundation for future studies on the regulation of lignin synthesis and stone cell development in pear fruit utilizing molecular biology approaches.
Epley manoeuvre’s efficacy for benign paroxysmal positional vertigo (BPPV) in primary-care and subspecialty settings: a systematic review and meta-analysis
Authors: Saishoji Yusuke , Yamamoto Norio , Fujiwara Takashi , Mori Hideki , Taito Shunsuke 
Published: December 2023

Abstract
Background
Although previous studies have reported general inexperience with the Epley manoeuvre (EM) among general physicians, no report has evaluated the effect of EM on benign paroxysmal positional vertigo (BPPV) in primary care by using point estimates or certainty of evidence. We conducted this systematic review and meta-analysis and clarified the efficacy of EM for BPPV, regardless of primary-care and subspecialty settings.

Methods
Systematic review and meta-analysis of randomised sham-controlled trials of EM for the treatment of posterior canal BPPV in primary-care and subspecialty settings. A primary-care setting was defined as a practice setting by general practitioners, primary-care doctors, or family doctors. A systematic search was conducted in January 2022 across databases, including Cochrane Central Resister of Controlled Trial, MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. Primary outcomes were the disappearance of subjective symptoms (vertigo), negative findings (Dix–Hallpike test), and all adverse events. We evaluated the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation approach.

Results
Twenty-seven randomised controlled trials were identified. In primary-care settings, EM reduced the subjective symptoms [risk ratio (RR), 3.14; 95% confidence interval (CI), 1.96–5.02]; however, there was no applicable article for all adverse events. In the subspeciality setting, EM reduced the subjective symptoms (RR, 2.42; 95% CI, 1.64–3.56), resulting in an increase in negative findings (RR, 1.81; 95% CI, 1.40–2.34). The evidence exhibited uncertainty about the effect of EM on negative findings in primary-care settings and all adverse events in subspecialty settings.

Conclusions
Regardless of primary-care and subspecialty settings, EM for BPPV was effective. This study has shown the significance of performing EM for BPPV in primary-care settings. EM for BPPV in a primary-care setting may aid in preventing referrals to higher tertiary care facilities and hospitalisation for follow-up.

Trial registration
The study was registered in protocols.io (PROTOCOL INTEGER ID: 51,464) on July 11, 2021.
Creating a supportive environment for older adults in China ——exploring factors associated with the need for home modifications based on a cross-sectional survey in Central China
Authors: Li Jiajing , Wu Bei , Wang Jing 
Published: December 2023

Abstract
Background
A supportive home environment is critical to the safety and quality of life of older adults. Home modification is an effective way to build a supportive home environment for older adults’ aging in place. However, there is a lack of knowledge on older adults’ need for home modifications in China.

Methods
We conducted a cross-sectional survey in three provinces of China (Hubei, Hunan, and Henan) using stratified and cluster sampling methods in 2021. A total of 5485 older adults aged 60 and over were included. The outcome variables were: need for home modifications, level of need, and type of modification needed. Exposure variables included: demographic and socioeconomic characteristics, as well as health conditions. Logistic and Poisson regressions were applied to examine the needs for home modifications and its associated factors.

Results
Nearly 30% of the older adults needed home modifications. The most common choice of home modification was the need for handrails at the bedside, toilet, or threshold (31.64%), and paving un-slip tiles or vinyl flooring (17.45%). Age (IRR = 1.01, P < 0.001), education (IRR = 1.11, P < 0.01), and level of assistance (IRR = 2.31, P < 0.001) were more likely to be positively associated with needs for modification. Participants in the age group of 70 to 79 years, with primary school education, and low-level physically dependent had significantly higher needs for modifications than those of advanced age, lower level of education, or higher level of physically dependent (p < 0.01).

Conclusions
The overall need for home modifications in China is low. Home modification programs are needed to tailor individuals’ needs and provide services to those with the most home modification need.
Pooled prevalence of lymphopenia in all-cause hospitalisations and association with infection: a systematic review and meta-analysis
Authors: Elçioğlu ZC , Errington L , Metes B , Sendama W , Powell J , Simpson AJ , Rostron AJ , Hellyer TP 
Published: December 2023

Abstract
Background
Lymphopenia is defined as a decrease below normal value (often 1.0 x 109 cells/L) of blood circulating lymphocyte count. In the general population, lymphopenia is associated with an increased risk of hospitalisation secondary to infection, independent of traditional clinical risk factors. In hospital, lymphopenia is associated with increased risk of healthcare-associated infection and mortality. By summarising lymphopenia’s prevalence and impact on clinical outcomes, we can identify an at-risk population and inform future studies of immune dysfunction following severe illness.

Methods
Peer-reviewed search strategy was performed on three databases. Primary objective was to summarise the pooled prevalence of lymphopenia. Primary outcome was infection including pre-existing lymphopenia as a risk factor for admission with infection and as an in-hospital risk factor for healthcare-associated infection. Secondary outcomes were length of stay and mortality. Mortality data extracted included in-hospital, 28/30-day (‘early’), and 90-day/1-year (‘late’) mortality. Meta-analysis was carried out using random-effects models for each outcome measure. Heterogeneity was assessed using I2 statistic. Joanna Briggs Institute checklist for cohort studies was used to assess risk of bias. The protocol was published on PROSPERO.

Results
Fifteen observational studies were included. The pooled prevalence of lymphopenia in all-cause hospitalisations was 38% (CI 0.34-0.42, I2= 97%, p< 0.01). Lymphopenia was not associated with an infection diagnosis at hospital admission and healthcare associated infection (RR 1.03; 95% CI 0.26-3.99, p=0.97, I2 = 55% and RR 1.31; 95% CI 0.78-2.20, p=0.31, I2=97%, respectively), but was associated with septic shock (RR 2.72; 95% CI 1.02-7.21, p=0.04, I2 =98%). Lymphopenia was associated with higher in-hospital mortality and higher ‘early’ mortality rates (RR 2.44; 95% CI 1.71-3.47, p < 0.00001, I2 = 89% and RR 2.05; 95% CI 1.64-2.56, p < 0.00001, I2 = 29%, respectively). Lymphopenia was associated with higher ‘late’ mortality (RR 1.59; 1.33-1.90, p < 0.00001, I2 = 0%).

Conclusions
This meta-analysis demonstrates the high prevalence of lymphopenia across all-cause hospitalisations and associated increased risk of septic shock, early and late mortality. Lymphopenia is a readily available marker that may identify immune dysfunctional patients. Greater understanding of immune trajectories following survival may provide insights into longer-term poor clinical outcomes.
How is the COVID-19 pandemic impacting our life, mental health, and well-being? Design and preliminary findings of the pan-Canadian longitudinal COHESION study
Authors: Gabet Stephan , Thierry Benoit , Wasfi Rania , Simonelli Guido , Hudon Catherine , Lessard Lily , Dubé Ève , Nasri Bouchra , Kestens Yan , Moullec Grégory 
Published: December 2023

Abstract
Background
With the advent of the COVID-19 pandemic, in-person social interactions and opportunities for accessing resources that sustain health and well-being have drastically reduced. We therefore designed the pan-Canadian prospective COVID-19: HEalth and Social Inequities across Neighbourhoods (COHESION) cohort to provide a deeper understanding of how the COVID-19 pandemic context affects mental health and well-being, key determinants of health, and health inequities.

Methods
This paper presents the design of the two-phase COHESION Study, and descriptive results from the first phase conducted between May 2020 and September 2021. During that period, the COHESION research platform collected monthly data linked to COVID-19 such as infection and vaccination status, perceptions and attitudes regarding pandemic-related measures, and information on participants’ physical and mental health, well-being, sleep, loneliness, resilience, substances use, living conditions, social interactions, activities, and mobility.

Results
The 1,268 people enrolled in the Phase 1 COHESION Study are for the most part from Ontario (47%) and Quebec (33%), aged 48 ± 16 years [mean ± standard deviation (SD)], and mainly women (78%), White (85%), with a university degree (63%), and living in large urban centers (70%). According to the 298 ± 68 (mean ± SD) prospective questionnaires completed each month on average, the first year of follow-up reveals significant temporal variations in standardized indexes of well-being, loneliness, anxiety, depression, and psychological distress.

Conclusions
The COHESION Study will allow identifying trajectories of mental health and well-being while investigating their determinants and how these may vary by subgroup, over time, and across different provinces in Canada, in varying context including the pandemic recovery period. Our findings will contribute valuable insights to the urban health field and inform future public health interventions.
Serum lipoprotein(a) and reclassification of coronary heart disease risk; application of prediction in a cross-sectional analysis of an ongoing Iranian cohort
Authors: Ghavami Mojgan , Abdshah Alireza , Esteghamati Sadaf , Hafezi-Nejad Nima , Nakhjavani Manouchehr , Esteghamati Alireza 
Published: December 2023

Abstract
Introduction
Recent studies have introduced elevated lipoprotein(a) (Lp(a)) as a risk factor for coronary heart disease (CHD). This study investigated whether the addition of Lp(a) as a novel biomarker to the Framingham Risk Score (FRS) model improves CHD risk prediction.

Methods
The study included 1101 Iranian subjects (443 non-diabetic and 658 diabetic patients) who were followed for 10 years (2003–2013). Lp(a) levels and CHD events were recorded for each participant.

Results
The Net Reclassification Index (NRI) after adding Lp(a) to the FRS model was 19.57% and the discrimination slope was improved (0.160 vs. 0.173). The Akaike Information Criterion (AIC), a measure of model complexity, decreased significantly after adding Lp(a) to the FRS model (691.9 vs. 685.4, P value: 0.007).

Conclusions
The study concluded that adding Lp(a) to the FRS model improves CHD risk prediction in an Iranian population without making the model too complex. This could help clinicians to better identify individuals who are at risk of developing CHD and to implement appropriate preventive measures.
Women’s autonomy in healthcare decision making: a systematic review
Authors: Idris Idayu Badilla , Hamis Amy Azira , Bukhori Ayuzeity Bistari Md , Hoong David Chan Chee , Yusop Hakimah , Shaharuddin Muhammad Al-Amin , Fauzi Nazmeen Adline Fawwazah A. , Kandayah Thinakaran 
Published: December 2023

Abstract
Objectives
Although there are calls for women’s empowerment and gender equity globally, there are still large disparities regarding women’s autonomy in healthcare decision making. The autonomy of women is believed to be crucial in improving their health-related outcomes. This review discusses factors that influence autonomy among women in healthcare decision making.

Design
Systematic review.

Data sources
PubMed, Web of Science and Scopus were searched from 2017–2022.

Eligibility criteria
The inclusion criteria include original articles, case studies and reports that has been written in the English Language, while manuscripts with no full article, reviews, newspaper reports, grey literatures, and articles that did not answer the review objectives were excluded.

Data extraction and synthesis
We carried out data extraction using a standardized data extraction form, that has been organized using Microsoft Excel. A narrative synthesis was carried out to combine the findings of all included articles.

Results
A total of 70 records were identified and 18 were reviewed, yielding eight articles to be included in the accepted list of studies. All studies were conducted in developing countries and most of the studies were cross sectional. Factors that were associated with women’s autonomy in healthcare decision making were age, women’s education and occupation, husbands’/partners’ education and occupation, residential location or region of residence, household wealth index as well as culture and religion.

Conclusions
Identification of these factors may help stakeholders in improving women’s autonomy in healthcare decision making. Policymakers play a crucial role in healthcare decision making by enacting laws and policies that protect women's rights, promoting gender-sensitive healthcare services, ensuring access to comprehensive information, promoting health education, and supporting vulnerable populations. These efforts ensure women's autonomy including able to access to unbiased and effective healthcare services.