bluuebunny/crossref_metadata_2025_split huggingface dataset:
Significance of serum sestrin2 as a biomarker of severity and functional outcome in acute intracerebral hemorrhage: a prospective observational longitudinal study
Authors: Dou Xianghong , Dong Wensheng , Gu Yanmei , Zhang Tingting , Zhang Jianhua 
Published: November 2023

Abstract
Background
Sestrin2 is a highly conserved stress-inducible protein with neuroprotective properties. Herein, we investigated the prognostic significance of serum sestrin2 in human intracerebral hemorrhage (ICH).

Methods
In this prospective observational longitudinal study, we enrolled 126 patients with supratentorial ICH as cases together with 126 healthy individuals as controls. Severity indicators were National Institutes of Health Stroke Scale (NIHSS) and hematoma volume. Prognostic parameters were early neurologic deterioration (END) and post-stroke 6-month poor prognosis [modified Rankin Scale (mRS) scores of 3–6]. Multivariate analysis was performed to assess relations of serum sestrin2 levels to severity and prognosis.

Results
Patients had statistically significantly higher serum sestrin2 levels than controls. Serum sestrin2 levels of patients were independently correlated with NIHSS scores and hematoma volume, as well as were substantially elevated in order of mRS scores from 0 to 6. Serum sestrin2 was identified as an independent predictor of END and poor prognosis. Based on the receiver operating characteristic curve, serum sestrin2 had a similar predictive ability for END and poor prognosis, as compared to NIHSS scores and hematoma volume. Prediction models of END and poor prognosis, in which serum sestrin2, NIHSS scores and hematoma volume were integrated, were visually described via nomogram, were reliable and stable under calibration curve and were of clinical benefit using decision curve analysis. Also, prediction model of poor prognosis showed dramatically higher discriminatory efficiency than any of NIHSS scores, hematoma volume and serum sestrin2.

Conclusion
Serum sestrin2 levels, which are obviously increased following acute ICH, are independently related to illness severity and poor clinical outcomes, substantializing serum sestrin2 as a clinically valuable prognostic biomarker of ICH.
Association study for the role of MMP8 gene polymorphisms in Colorectal cancer susceptibility
Authors: Yu Shuyong , Cheng Jiajia , Li Ping , Tian Le , Chen Zhuang , Chen Zhaowei , Li Yongyu , Song Jian 
Published: November 2023

Abstract
Background
Colorectal cancer (CRC) is one of the most common malignant tumors, influenced by several genetic loci in its clinical phenotypes. The aim of this study was to determine the relationship between the MMP8 gene polymorphism and CRC risk in the Chinese Han population.

Method
This study recruited 688 CRC patients and 690 healthy controls. The relationship between MMP8 polymorphism and CRC susceptibility was assessed by calculating the odds ratio (OR) and 95% confidence interval (CI) after stratifying by age, gender, body mass index (BMI), smoking, and alcohol consumption under a multi-genetic model.

Results
MMP8 rs3740938 was associated with increased CRC predisposition (p = 0.016, OR = 1.24, 95% CI: 1.04–1.48), and this association was detected particularly in subjects aged > 60 years, females, people with BMI > 24 kg/m2, smokers, and drinkers. Moreover, rs3740938 was found to be associated with the pathological type of rectal cancer.

Conclusions
Our results first displayed that rs3740938 in MMP8 was a risk factor for CRC predisposition. This finding may provide a new biological perspective for understanding the role of the MMP8 gene in CRC pathogenesis.
Common myths and misconceptions about breast cancer causation among Palestinian women: a national cross-sectional study
Authors: Elshami Mohamedraed , Ismail Islam Osama , Alser Mohammed , Al-Slaibi Ibrahim , Ghithan Roba Jamal , Usrof Faten Darwish , Qawasmi Malak Ayman Mousa , Okshiya Heba Mahmoud , Shurrab Nouran Ramzi Shaban , Mahfouz Ibtisam Ismail , Fannon Aseel AbdulQader , Hawa Mona Radi Mohammad , Giacaman Narmeen , Ahmaro Manar , Zaatreh Rula Khader , AbuKhalil Wafa Aqel , Melhim Noor Khairi , Madbouh Ruba Jamal , Hziema Hala Jamal Abu , Lahlooh Raghad Abed-Allateef , Ubaiat Sara Nawaf , Jaffal Nour Ali , Alawna Reem Khaled , Abed Salsabeel Naeem , Abuzahra Bessan Nimer Ali , Kwaik Aya Jawad Abu , Dodin Mays Hafez , Taha Raghad Othman , Alashqar Dina Mohammed , Mobarak Roaa Abd-al-Fattah , Smerat Tasneem , Albarqi Shurouq I. , Abu-El-Noor Nasser , Bottcher Bettina 
Published: November 2023

Abstract
Background
The discussion about breast cancer (BC) causation continues to be surrounded by a number of myths and misbeliefs. If efforts are misdirected towards reducing risk from false mythical causes, individuals might be less likely to consider and adopt risk-reducing behaviors for evidence-based BC causes. This national study aimed to assess the awareness of BC causation myths and misbeliefs among Palestinian women, and examine the factors associated with having good awareness.

Methods
This national cross-sectional study recruited adult women from government hospitals, primary healthcare centers, and public spaces in 11 governorates in Palestine. A modified version of the Cancer Awareness Measure-Mythical Causes Scale was used to collect data. The level of awareness of BC causation myths was determined based on the number of myths recognized to be incorrect: poor (0–5), fair (6–10), or good (11–15).

Results
A total of 5,257 questionnaires were included. Only 269 participants (5.1%) demonstrated good awareness (i.e., recognizing more than 10 out of 15 BC mythical causes). There were no notable differences in displaying good awareness between the main areas of Palestine, the Gaza Strip and the West Bank and Jerusalem (5.1% vs. 5.1%). Having chronic disease as well as visiting hospitals and primary healthcare centers were associated with a decrease in the likelihood of displaying good awareness.
Myths related to food were less frequently recognized as incorrect than food-unrelated myths. ‘Eating burnt food’ was the most recognized food-related myth (n = 1414, 26.9%), while ‘eating food containing additives’ was the least recognized (n = 599, 11.4%). ‘Having a physical trauma’ was the most recognized food-unrelated myth (n = 2795, 53.2%), whereas the least recognized was ‘wearing tight bra’ (n = 1018, 19.4%).

Conclusions
A very small proportion of Palestinian women could recognize 10 or more myths around BC causation. There is a substantial need to include clear information about BC causation in future educational interventions besides focusing on BC screening, signs and symptoms, and risk factors.
Having a real say: findings from first nations community panels on pandemic influenza vaccine distribution
Authors: Crooks Kristy , Taylor Kylie , Burns Kiara , Campbell Sandy , Degeling Chris , Williams Jane , Andrews Ross , Massey Peter , McVernon Jodie , Miller Adrian 
Published: November 2023

Abstract
Background
Recent deliberations by Australian public health researchers and practitioners produced an ethical framework of how decisions should be made to distribute pandemic influenza vaccine. The outcome of the deliberations was that the population should be considered in two categories, Level 1 and Level 2, with Level 1 groups being offered access to the pandemic influenza vaccine before other groups. However, the public health researchers and practitioners recognised the importance of making space for public opinion and sought to understand citizens values and preferences, especially First Nations peoples.

Methods
We conducted First Nations Community Panels in two Australian locations in 2019 to assess First Nations people’s informed views through a deliberative process on pandemic influenza vaccination distribution strategies. Panels were asked to make decisions on priority levels, coverage and vaccine doses.

Results
Two panels were conducted with eighteen First Nations participants from a range of ages who were purposively recruited through local community networks. Panels heard presentations from public health experts, cross-examined expert presenters and deliberated on the issues. Both panels agreed that First Nations peoples be assigned Level 1 priority, be offered pandemic influenza vaccination before other groups, and be offered two doses of vaccine. Reasons for this decision included First Nations people’s lives, culture and families are important; are at-risk of severe health outcomes; and experience barriers and challenges to accessing safe, quality and culturally appropriate healthcare. We found that communication strategies, utilising and upskilling the First Nations health workforce, and targeted vaccination strategies are important elements in pandemic preparedness and response with First Nations peoples.

Conclusions
First Nations Community Panels supported prioritising First Nations peoples for pandemic influenza vaccination distribution and offering greater protection by using a two-dose full course to fewer people if there are initial supply limitations, instead of one dose to more people, during the initial phase of the vaccine roll out. The methodology and findings can help inform efforts in planning for future pandemic vaccination strategies for First Nations peoples in Australia.
Research on the relationship between common metabolic syndrome and meteorological factors in Wuhu, a subtropical humid city of China
Authors: Zhang Tao , Ni Man , Jia Juan , Deng Yujie , Sun Xiaoya , Wang Xinqi , Chen Yuting , Fang Lanlan , Zhao Hui , Xu Shanshan , Ma Yubo , Zhu Jiansheng , Pan Faming 
Published: November 2023

AbstractAs climate conditions deteriorate, human health faces a broader range of threats. This study aimed to determine the risk of death from metabolic syndrome (MetS) due to meteorological factors. We collected daily data from 2014 to 2020 in Wuhu City, including meteorological factors, environmental pollutants and death data of common MetS (hypertension, hyperlipidemia and diabetes), as well as a total number of 15,272 MetS deaths. To examine the relationship between meteorological factors, air pollutants, and MetS mortality, we used a generalized additive model (GAM) combined with a distributed delay nonlinear model (DLNM) for time series analysis. The relationship between the above factors and death outcomes was preliminarily evaluated using Spearman analysis and structural equation modeling (SEM). As per out discovery, diurnal temperature range (DTR) and daily mean temperature (T mean) increased the MetS mortality risk notably. The ultra low DTR raised the MetS mortality risk upon the general people, with the highest RR value of 1.033 (95% CI: 1.002, 1.065) at lag day 14. In addition, T mean was also significantly associated with MetS death. The highest risk of ultra low and ultra high T mean occured on the same day (lag 14), RR values were 1.043 (95% CI: 1.010, 1.077) and 1.032 (95% CI: 1.003, 1.061) respectively. Stratified analysis’s result showed lower DTR had a more pronounced effect on women and the elderly, and ultra low and high T mean was a risk factor for MetS mortality in women and men. The elderly need to take extra note of temperature changes, and different levels of T mean will increase the risk of death. In warm seasons, ultra high RH and T mean can increase the mortality rate of MetS patients.
The relationship between social support and academic engagement among university students: the chain mediating effects of life satisfaction and academic motivation
Authors: Chen Chunmei , Bian Fei , Zhu Yujie 
Published: November 2023

Abstract
Background
University students’ academic engagement has a significant impact on their academic performance and career development.

Methods
In order to explore the influential mechanisms of social support on university students’ academic engagement and the mediating role of academic motivation and life satisfaction, this study used the Adolescent Social Support Scale, University Students’ Academic Engagement Scale Questionnaire, Adolescent Student Life Satisfaction Scale and University Students’ Academic Motivation Questionnaire, to conduct a questionnaire survey and empirical analysis on 2106 Chinese university students.

Results
(1) social support significantly and positively predicts academic engagement; (2) social support influences academic engagement through the mediating effect of life satisfaction; (3) social support influences academic engagement through the mediating effect of academic motivation; (4) life satisfaction and academic motivation play a chain mediating role in the effect of social support on academic engagement.

Conclusions
This study contributes to understanding the underlying mechanisms of the relationship between social support and academic engagement, which in turn provides insights for universities and the departments concerned to make measures to improve the level of university students’ academic engagement.
Parental separation, negative life events and mental health problems in adolescence
Authors: Karhina Kateryna , Bøe Tormod , Hysing Mari , Nilsen Sondre Aasen 
Published: November 2023

Abstract
Background
Parental separation is associated with mental health problems in adolescence. One suggested pathway for this association is through the accumulated exposure to stress and other negative life events. This study aimed to document the distribution of negative life events among adolescents with separated compared to non-separated parents, and to assess the direct and interactive associations between parental separation, negative life events, and mental health problems in adolescence.

Methods
Data stem from the cross-sectional population-based youth@hordaland study of adolescents (aged 16–19) conducted in Norway in 2012, providing self-reported information about parental separation, negative life events, and depression-, anxiety-, conduct-, and ADHD symptoms. Regression analyses were used to assess the direct and interactive associations between parental separation, negative life events, and mental health problems.

Results
Adolescents with separated parents had more mental health problems across all symptom scales compared to peers with non-separated parents, with standardized mean differences [SMDs] ranging from 0.15 to 0.20. Negative life events moderately attenuated these differences (reduced the SMDs with about 0.04–0.08, depending on the outcome). However, none of the interactions between parental separation and negative life events on mental health problems were statistically significant.

Conclusions
Higher exposure to negative life events explains parts of the association between parental separation and mental health problems in adolescence. However, a parental separation does not seem to increase the vulnerability of the effects of negative life events on adolescents’ mental health. Assessing exposure to negative life events is important when providing mental health services to adolescents, particularly to those who have parents separated.
Sex differences in comorbidities and mortality risk among patients with chronic obstructive pulmonary disease: a study based on NHANES data
Authors: Li Na , Li Xiaoli , Liu Minjie , Wang Yakang , Wang Junning 
Published: November 2023

Abstract
Background
Patients with chronic obstructive pulmonary disease (COPD) commonly have coexisting comorbidities that contribute to higher exacerbation frequency, poorer health status, and increased all-cause mortality; however, there are only a few studies available on the sex discrepancy in the comorbidity distribution and outcomes among COPD patients, and there is limited information about the discrepancy in all-cause mortality between men and women.

Methods
Based on data from the U.S. National Health and Nutrition Examination Survey conducted between 2007 and 2012, we compared participants aged 40–79 years with spirometry-defined COPD to compare the prevalence of comorbidities between men and women. The survival of the subjects was documented, and the sex discrepancy was determined using Kaplan–Meier analysis. Comorbidities and all-cause mortality were analyzed by using a Cox proportional hazards model to determine their strength of association in different sex groups.

Results
Compared to men, women had a significantly higher prevalence of asthma (OR 1.93, 95% CI 1.46 to 2.57, p < 0.001) and arthritis (OR 1.77, 95% CI 1.39 to 2.24, p < 0.001). Women had a significantly lower prevalence of coronary heart disease (OR 0.48, 95% CI 0.27 to 0.87, p = 0.015) and gout (OR 0.42, 95% CI 0.25 to 0.67, p = 0.001). Kaplan–Meier analysis revealed that compared with that of the female group, the survival rate of the male group was significantly lower (p < 0.001). Among men, the presence of anemia (HR 2.38, [95% CI 1.52–3.73], p < 0.001), gout (HR 1.55, [95% CI 1.04–2.30], p = 0.029) and congestive heart failure comorbidities (HR 1.85, [95% CI 1.12–3.04] p = 0.016) was associated with a higher risk of mortality; among women, the presence of anemia (HR 2.21, [95% CI 1.17–4.20], p = 0.015) and stroke (HR 2.04, [95% CI 1.07–3.88], p = 0.031) comorbidities was associated with a higher risk of mortality after adjusting for age, race/Hispanic status, BMI, smoking status, FEV1% predicted and prevalent comorbidities.

Conclusions
COPD-related comorbidities and all-cause mortality were discrepant between men and women, and men had poorer survival than women in the nationally representative data that were analyzed.
Thyroid function and opium use disorder: a cross-sectional study on the Fasa adults cohort study (FACS), 2017
Authors: Pezeshki Babak , Pourmontaseri Hossein , Homayounfar Reza , Moghaddam Maryam Talebi , Dehghan Azizallah 
Published: November 2023

Abstract
Background
Addiction increases the risk of different lifelong disorders. However, there are limited studies evaluating the effects of opioid use disorder (OUD) on thyroid function. The present study aimed to compare the thyroid function of individuals with and without OUD.

Methods
This cross-sectional study was conducted on 700 eligible participants of the Persian Cohort of Fasa, Iran. Pregnant women and participants with false or missing data were excluded from the study. Remained participants were divided into case and control groups based on the recorded history of OUD. Frozen plasma samples of the cohort bank were used to determine the levels of T3, T4, and thyroid-stimulating hormone (TSH). The thyroid function was compared between the two groups using the Mann-Whitney test (P < 0.05).

Results
The mean age of the final studied population (n = 648) was 54.0 ± 9.8 years, including 336 men (49.1%) and 197 participants with OUD (28.8%). The median levels of TSH, T4, and T3 were 2.91 ± 4.61, 9.26 ± 3.65, and 1.22 ± 0.49, respectively. The case group had significantly higher TSH (3.72 ± 6.2 vs. 2.58 ± 3.75, P < 0.001) and lower T4 (8 ± 3.6 vs. 9.8 ± 3.5, P < 0.001). Also, T3 was slightly lower in the case group (1.1 ± 0.5 vs. 1.3 ± 0.5; P = 0.369), although this association was only significant in female opium users (P < 0.001).

Conclusions
The present findings revealed that OUD caused a reduction in T4 while increasing TSH. Therefore, OUD may lead to the development of primary hypothyroidism, which needs to be investigated in future studies.
Prevalence and correlates of multimorbidity among patients attending AYUSH primary care settings in Delhi-National Capital Region, India
Authors: Varanasi Roja , Sinha Abhinav , Nayak Debadatta , Manchanda Raj K. , Janardhanan Rajiv , Tandon Simran , Pati Sanghamitra 
Published: November 2023

Abstract
Introduction
India has a multifaceted healthcare system and recognizes complementary and alternative systems of medicine (AYUSH) that cater to the healthcare needs of people. Multimorbidity requires frequent visits to physicians and long-term use of medications, due to which people tend to prefer AYUSH systems as they provide holistic patient-centered treatment. Hence, we aimed to estimate the prevalence of multimorbidity and assess its correlates among patients attending AYUSH primary care clinics in Delhi.

Methods
A cross-sectional study was conducted among 943 patients aged ≥ 18 years attending various AYUSH primary care clinics in Delhi from September 2021 to February 2022, employing a stratified random sampling technique. Descriptive statistics such as frequency and proportion were used to report the prevalence of multimorbidity (two or more chronic conditions in an individual out of the 33 conditions listed as per the Multimorbidity Assessment Questionnaire for Primary Care). A multivariable logistic regression assessed the association between various socio-demographic characteristics and multimorbidity, presented as an adjusted odds ratio (AOR) with a 95% confidence interval (CI).

Results
The prevalence of diabetes (14.7%) was found to be the highest (out of all included chronic conditions) among the patients attending various AYUSH primary care settings. The overall prevalence of multimorbidity was observed to be around 39.4%. We observed a higher likelihood of having multimorbidity among participants aged ≥ 70 years [AOR: 9.19 (95% CI: 3.75–22.54)], females [AOR: 1.57 (95% CI: 1.04–2.37)], and middle class [AOR: 2.23 (95% CI: 1.45–3.43)].

Conclusion
Multimorbidity was evidently prevalent across AYUSH primary care settings, which cannot be overlooked. The results suggest behavioral change communication may be aimed at older individuals, females, and the middle class.
Evaluation of causal associations between interleukin-18 levels and immune-mediated inflammatory diseases: a Mendelian randomization study
Authors: Wu Jialing , Zhang Xi , Wu Dongze , Jin Ou , Gu Jieruo 
Published: November 2023

Abstract
Background
Altered interleukin (IL)-18 levels are associated with immune-mediated inflammatory diseases (IMIDs), but no studies have investigated their causal relationship. This study aimed to examine the causal associations between IL-18 and IMIDs.

Methods
We performed a two-sample Mendelian randomization (MR) analysis. Genetic variants were selected from genome-wide association study datasets following stringent assessments. We then used these variants as instrumental variables to estimate the causal effects of IL-18 levels on the risk of developing five common IMIDs: rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), inflammatory bowel disease (IBD), ankylosing spondylitis (AS), and psoriasis. We used the inverse variance-weighted (IVW) method as the primary analysis, with sensitivity analyses performed to avoid potential bias. Reverse-direction MR analyses were performed to rule out the possibility of reverse associations.

Results
We found that genetically determined higher circulating IL-18 levels were causally associated with a higher risk for SLE (PIVW = 0.009; OR, 1.214; 95% CI, 1.049 − 1.404) and IBD (PIVW < 0.001; OR, 1.142; 95% CI, 1.062 − 1.228), but found no significant associations of IL-18 with RA (PIVW = 0.496; OR, 1.044; 95% CI, 0.923 − 1.180), AS (PIVW = 0.021; OR, 1.181; 95% CI, 1.025 − 1.361), or psoriasis (PIVW = 0.232; OR, 1.198; 95% CI, 0.891 − 1.611). In the reverse direction, no causal relationship existed between SLE or IBD and IL-18 levels. Globally, sensitivity studies using alternative MR methods supported the results that were robust and reliable. The Cochran’s Q test, MR-Egger intercept, and MR-Pleiotropy RESidual Sum and Outlier excluded the influence of heterogeneity, horizontal pleiotropy, and outliers.

Conclusions
We have demonstrated that elevated IL-18 levels increase the risk of SLE and IBD but not RA, AS, or psoriasis. The results enhanced our understanding of IL-18 in the pathology of IMIDs.