bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perspectives of Older Adults on COVID-19 and Influenza Vaccination in Ontario, Canada
Authors: Music Milena , Taylor Nicholas , McChesney Christopher , Krustev Christian , Chirila Alexandra , Ji Catherine 
Published: December 2023

Introduction/Objectives: Addressing vaccine hesitancy has become an increasingly important public health priority in recent years. There is a paucity of studies that have focused on vaccine hesitancy among older adults, who are known to be at greater risk of complications from infections such as COVID-19. We aim to explore the attitudes and beliefs of older adults regarding COVID-19 and influenza vaccines in Toronto, Ontario. Methods: Older adults enrolled in the Student Senior Isolation Prevention Partnership (SSIPP) program at the University of Toronto were contacted to participate in a phone survey and semi-structured interview. Survey data was analyzed descriptively, and attitude toward vaccination was compared between sociodemographic groups by using Fisher’s exact test. Interview audio files were transcribed verbatim and analyzed inductively for themes and sub-themes. Results: All thirty-three (100%) older adults reported that they had received the first and second doses of the COVID-19 vaccine. Twenty-six (78.8%) participants reported intent to get vaccinated against influenza or had already received the influenza vaccine that year. Notably, only 2 out 7 (28.6%) individuals who did not plan to get vaccinated against influenza believed that vaccines offered by health providers are beneficial and only 3 out of 7 (42.9%) agreed that getting vaccines is a good way to protect oneself from disease. No other significant differences in attitudes among participants were found when compared by gender, ethnicity, or education level. The qualitative data analysis of interview transcripts identified 5 themes that impact vaccine decision making: safety, trust, mistrust, healthcare experience, and information dissemination and education. Conclusions: Our data showed that older adults in the SSIPP program generally had positive views toward vaccination, especially toward the COVID-19 vaccines. However, several concerns regarding the effectiveness of the vaccines were brought up in interviews, such as the speed at which the vaccines were produced and the inconsistency in government messaging.
Assessing Social Needs and Engaging Community Health Workers in Underserved Kansas Counties: Insights From Primary Care Providers and Clinic Managers
Authors: Bridges Kristina M. , LeMaster Joseph W. , Parente Daniel J. , Pacheco Christina M. , Schultz Christine , Morrow Emily , Corriveau Erin , Miras Neira Ton , Greiner K. Allen , Woodward Jennifer , Anders- Rumsey Jordan , Cirotski Daniel , Finocchario-Kessler Sarah , Ellerbeck Edward F. 
Published: December 2023

Introduction: Rural and under-resourced urban communities face unique challenges in addressing patients’ social determinants of health needs (SDoH). Community health workers (CHWs) can support patients experiencing social needs, yet little is known about how rural and under-resourced primary care clinics are screening for SDoH or utilizing CHWs. Methods: Interviews were conducted with primary care clinic providers and managers across a geographically large and predominately rural state to assess screening practices for SDoH and related community resources, and perspectives on using CHWs to address SDoH. Interviews were conducted by phone, recorded, and transcribed. Data were analyzed using thematic analysis. We completed interviews with 27 respondents (12 providers and 15 clinic managers) at 26 clinics. Results: Twelve (46.1%) clinics had a standardized process for capturing SDoH, but this was primarily limited to Medicare wellness visits. Staffing and time were identified as barriers to proper SDoH screening. Lack of transportation and affordable medication were the most cited SDoH. While respondents were all aware of CHWs, only 8 (30.8%) included a CHW on their care team. Perceived barriers to engaging CHWs included cost, space, and availability of qualified CHWs. Perceived benefits of engaging CHWs in their practice were: assisting patients with navigating resources and programs, relieving clinical staff of non-medical tasks, and bridging language barriers. Conclusions: Rural and under-resourced primary care clinics need help in identifying and addressing SDoH. CHWs could play an important part in addressing social needs and promoting preventive care if financial constraints could be addressed and local CHWs could be trained.
Short-Term Substitution of Calcineurin Inhibitors (CNIs) with Recombinant Humanized Anti-CD25 Monoclonal Antibody (anti-CD25 rhMAb) As aGVHD Prophylaxis in Cnis Intolerant Patients after Allogeneic Hematopoietic Stem Cell Transplantation
Authors: Shao Shan , Liu Huixia , Jiang Ying , Li Su , Wei Daolin , Zhu JUN , Wang Chun , Zhao Chuxian 
Published: December 2023

Objectives: To investigate the efficacy of short-term substitution of Recombinant humanized anti-CD25 monoclonal antibody (anti-CD25 rhMAb) as aGVHD prophylaxis in CNIs intolerant patients after allogeneic hematopoietic stem cell transplantation (Allo-HSCT).
Methods: From August 2021 to August 2022, seventeen patients with refractory hematologic malignancies after salvage Allo-HSCT were enrolled in our study. All were treated with anti-CD25 rhMAb as GVHD prophylaxis due to severe CNIs intolerance such as acute renal dysfunction, central nervous system complications (CNSC) or endothelial injury syndromes. There were seven males and ten females, with a median age of 43 years (18-67). After the withdrawal of CNIs, anti-CD25 rhMAb was applied at 1mg/Kg once a week until the reinstitution of CNIs or mTOR inhibitors.
Results: Anti-CD25 rhMAb was initiated at a median of 5 days (range: 1-32) after HSCT. The median duration of substitution was 20(7-120) days. All achieved neutrophil engraftment after a median of 12 days (range: 10-17). Thirteen patients had platelet engraftment after a median of 13 days (range: 11-20). Four patients did not achieve stable platelet engraftment. Eight patients (47.1%) developed Grade II-IV aGVHD, and four (23.6%) developed Grade III-IV aGVHD. Only one patient died of aGVHD. Until December 31, 2022, Seven of 17 patients died. The longest follow-up time of the survivors was 347 days, and the median survival was not reached. Overall survival (OS) at six months was 62.6%. OS at six months was 80.0% in the subgroup with CNSC.
Conclusions: When CNIs intolerance occurs during Allo-HSCT, Short-term replacement of CNIs with anti-CD25 rhMAb is an optional approach, which may provide a promising aGVHD prophylaxis for patients with CNIs intolerance.
Utility of Echocardiogram in Neutropenic Patients with Gram Positive Bacteremia: A Retrospective Study
Authors: Sternbach Neta , Raanani Pia , Yahav Dafna , Shragian Liat , Yeshurun Moshe , Wolach Ofir , Ben zvi Haim 
Published: December 2023

Introduction: Hemato-oncology patients are vulnerable to bloodstream infections (BSI) due to their immunocompromised and neutropenic state, and the common use of intravascular catheters. The risk of infective endocarditis (IE) among non-neutropenic patients with gram positive bacteremia is substantial, however the risk is considered to be lower among neutropenic patients, though data is limited. We aimed to evaluate the incidence of IE among neutropenic hemato-oncology patients' cohort, and to explore the yield of echocardiogram in this specific population.
Methods: A single center, retrospective study. Between 01/2007 and 12/2019, hospitalized patients in the Hematology department consisting of the hemato-oncology and bone marrow transplantation units were included, if they had positive blood cultures for specific organisms known to cause IE while neutropenic. Patient characteristics, results and timing of blood cultures and echocardiogram obtained during hospitalization were collected.
Results: Two hundred seventy-four patients had positive blood cultures with pathogens known to be associated with IE. Overall, 340 isolates have been identified. After excluding 57 coagulase negative staphylococcus (CONS) isolates which were suspected as a contamination (identified in a single collection), 241 patients were included with 283 isolates. CONS were the most commonly isolates found, followed by streptococcus viridans, comprising 31.4% (89) and 24.3% (69) of isolates, respectively. Trans thoracic echocardiography (TTE) was performed in 108 (45%) patients overall, of which 14 (5.8%) had additional trans esophageal echocardiogram (TEE).
Only one case of IE was diagnosed in our series, of a forty-seven-year-old female patient with a diagnosis of multiple myeloma in relapse after autologous stem cell transplantation. The patient presented with a stroke caused by septic emboli, fever and streptococcus viridans bacteremia. Lab works showed neutropenia of 0K/micl and thrombocytopenia of 8K/micl. TTE and TEE failed to demonstrate valvular pathology consistent with IE in this case. Valvular vegetations have not been identified on TTE nor on TTE in any other case as well.
Conclusion In our experience, the yield of echocardiogram in hemato-oncological neutropenic patients with gram positive bacteremia is extremely low, owing to reduced probability of IE in this population, and thus could be avoided in most cases.
Implementation and Evaluation of Discharge Planning for Patients Undergoing Umbilical Cord Blood Transplantation
Authors: Huang Lu , Zhu Yan , Wu Yun , Wang Yingying , Song Kaidi , Zhu Xiaoyu , Song Guiqi , Wu Yaohua , Zhang Yongliang 
Published: December 2023

Purpose The purpose of this study was to implement discharge planning for patients undergoing umbilical cord blood transplantation (UCBT) and evaluate the effects on length of stay (LOS), hospital readmission, discharge readiness, self-efficacy, and quality of life (QoL).
Methods Participants (n =72) were assigned to a control group (CG: received usual care) or an intervention group (IG: received discharge planning from admission to 100 days after UCBT). LOS and the rate of hospital readmission within 30 days after discharge were collected. Discharge readiness was measured by the Readiness for Hospital Discharge Scale, self-efficacy and QoL were assessed at 100 days after UCBT using General Self-Efficacy Scale and FACT-BMT version 4.
Results Sixty-six patients completed the study, the IG group showed significantly better discharge readiness (p&lt;0.05), improvement in self-efficacy (p&lt;0.001). Except for social and emotional well-being, all the other dimensions and three total scores of FACT-BMT in the IG were higher than the controls (p&lt;0.05). The LOS was less in the IG (50.12±8.80 vs. 53.28±11.28, p=0.207), the rate of hospital readmission within 30 days after discharge was lower (20.59% vs. 31.25%, p=0.376), however, the differences were not significant.
Conclusion This study provided the evidences on the implementation of discharge planning for patients undergoing UCBT, and suggested that nurse-led discharge planning should be incorporated into usual care for successful hospital-to-home transitions.
Factors Associated with in-Hospital Mortality in Patients with Burkitt Lymphoma - Analysis of the National Inpatient Sample (NIS)
Authors: Pichardo Rayli , Ramo Aula , Abu Omar Yazan , Dabak Vrushali S. 
Published: December 2023

Introduction
Burkitt Lymphoma (BL) is a highly aggressive B-cell non-Hodgkin Lymphoma, characterized by translocation and dysregulation of the MYC gene. BL comes in three distinct forms: endemic, sporadic, and immunodeficiency-related. BL has become a highly curable disease after the development of intense chemo-immunotherapy regimens, but given the low incidence of the disease, nationally representative studies on outcomes are scarce. We aim to highlight the most recent population-based factors associated with inpatient mortality and morbidity in patients with Burkitt's lymphoma.
Methods
The National Inpatient Sample database was queried from October 2015 to December 2020.
Adults aged &gt;= 18 with a primary diagnosis of BL were identified and stratified into those with and without the outcome of mortality. Complications included were queried using ICD codes most commonly found in the secondary diagnosis variables. Baseline characteristics, inpatient complications, and outcomes were compared using chi-squared and Wilcoxon rank-sum tests. Logistic regression analysis was performed to assess the risk of death before and after adjusting for multiple risk factors.
Results
We found 3,650 admissions with a primary diagnosis of BL, of which 320 (8.8%) patients died during the hospitalization. Patients who died had higher Charlson Comorbidity Index (CCI) &gt;=3 (69%), tumor lysis syndrome (TLS) (41%), Sepsis (39%), and acute hypoxic respiratory failure (AHRF) (33%). No significant differences were found according to income, hospital bed-size or geographical region. In univariable analysis patients who died tended to be older with age &gt;= 65 years (OR 2.55 (1.23 to 5.26) p=0.039), however, once adjusting for other variables there was no significant difference in mortality by age group, race, or gender. Multivariable analysis identified 3 factors with high association with mortality: acute renal failure (OR 3.07 (1.63 to 5.76), p&lt;0.001), sepsis (OR 7.96 (3.85 to 16.4), p&lt;0.001), and acute hypoxic respiratory failure (OR 2.70 (1.23 to 5.92), p=0.013).
Conclusion
BL remains a highly aggressive but potentially curable disease in patients able to tolerate intensive chemo-immunotherapy regimens. Our study highlights multiple factors that are independently associated with death include acute renal failure, sepsis, and acute hypoxic respiratory failure. Close monitoring should be placed on patients with the above complications to improve survival.
Metabolomics-Driven Systematic Research Reveals Different Metabolomic and Lipidomic Profiling of Bone Marrow Plasma in Patients with Multiple Myeloma
Authors: Zhu Ziang , Li Yang , Li Jin-Yuan , Huang Han-Ying , Shuzhao Chen , Liu Yang , Liang Yang , Shu Lingling 
Published: December 2023

Myeloma cells resident in bone marrow (BM), therefore the microenvironment plays critical roles in the invasion, proliferation and migration. Obesity increases the morbidity and drug resistance in patient of multiple myeloma (MM) through changing the bone marrow environment. Extracellular environments such as the BM plasma likely have unique lipidomic metabolite profiles that predicts the prognosis in patients with multiple myeloma. However, the study of multiple omics on metabolic changes in BM of MM patients are still very limited.
The present study utilized an untargeted metabolite and targeted complex lipid profiling (Liquid chromatography-mass spectrometry, LC-MS) analysis to identify significant differences in the metabolite levels of BM plasma between newly diagnosed MM patients with different BMI (≤24 kg/m 2, n = 10; ≥25 kg/m 2, n = 10). This was followed by verification of some of the metabolite differences of interest by targeted quantification of the metabolites using isotopic internal standards in the exploratory cohort as well as an independent validation cohort.
Significant differences were noted in the amino acid profiles, lipid metabolism and amino sugar metabolism, such as increased L-Glutamate, L-Proline, D-Proline, palmitoleic acid and D-Fructose, etc between MM patients with different BMI ( Figure A-C). Glycerol phosphate shuttle, glycerolipid metabolism and de novo triacylglycerol biosynthesis were the top 3 enriched signaling pathways in BM of obese MM patients ( Figure D). Targeted complex lipid profiling analysis further showed that triglyceride (TG)，diglyceride (DG) were increased notably in obese BM plasma of MM patients and correlated significantly with BMI ( Figure E-G). Glycerolipids, triradylglycerols, diradylglycerols and fatty acyls metabolism were enriched in obese group by GSEA analysis ( Figure H). Furthermore, KEGG enrichment analysis showed differentiate expressed lipid metabolites in BM plasma of obese MM patients comparing to that of lean group, including regulation of lipolysis in adipocytes, glycerolipid metabolism, fat digestion and absorption, cholesterol metabolism and metabolic pathways, etc ( Figure I ).
In summary, metabolite and complex lipid profiling of the BM plasma identifies differences in levels of metabolites and lipids between MM patients with different BMI. This may provide insight into the explanation that obesity increases the susceptibility to MM and drug resistance.
Acknowledgement
This project is supported by the Sun Yat-sen University Hundred Talents Program (PT19200101), Natural Science Foundation of Guangdong Province (2022A1515010290).
Efficacy and Safety of Avatrombopag in the Treatment of Thrombocytopenia after Umbilical Cord Blood Transplantation
Authors: Huang Aijie , Sun Guangyu , Tang Baolin , Song Kaidi , Cheng Yaxin , Tu Meijuan , Wu Yue , Pan Tianzhong , Wang Dongyao , Zhu Xiaoyu 
Published: December 2023

Background: Delayed platelet engraftment is a common complication after umbilical cord blood transplantation (UCBT), and it has no standard therapy. Avatromboapg is a second generation thrombopoietin receptor agonist (TPO-RA) and showed efficacy in immune thrombocytopenia (ITP). However, few reports focused on its efficacy in patients diagnosed with thrombocytopenia after allogeneic hematopoietic stem cell transplantation (allo-HSCT).
Methods: We conducted a retrospective study to evaluate the efficacy of avatrombopag in 69 patients after UCBT as the first-line thrombopoietin receptor agonist (TPO-RA) treatment.
Results: Sixty-one patients were given avatrombopag to promote platelet engraftment, the other 8 for secondary failure of platelet recovery (SFPR). For the majority of patients (44/69, 63.8%), the initial dose was 40 mg daily. Among the 61 patients given avatrombopag for platelet engraftment, 40 achieved an overall response (OR) (65.6%), and the cumulative incidence of OR was 76.2% (95% CI, 61.3-86.0), at a median time of 23 days (range, 3-131 days). Thirty-eight of 61 (62.3%) patients achieved complete remission (CR), and the cumulative incidence of CR was 76.2% (95% CI, 61.1-86.1). Patients suffering from SFPR had a better cumulative incidence of OR [100% (95% CI, NA), P = 0.005]. Giving avatrombopag before 37 days post-UCBT was beneficial for OR in multivariate analysis.
Conclusion: In summary, our results indicate that avatrombopag could be used to promote platelet engraftment, especially in the early period (&lt; 37 days after UCBT). Patients with SFPR may have a better response to avatrombopag therapy.
Keywords: Avatrombopag; umbilical cord blood transplantation; thrombopoietin receptor agonist; secondary failure of platelet recovery
Conflict-of-interest disclosure: The authors declare that they have no competing interests.
Unveiling Gender Disparities: Female Authorship in Pivotal Trials for US Food and Drug Administration (FDA)-Approved Novel Chimeric Antigen Receptor T-Cell Therapies
Authors: Farooq Muhammad , Sohail Aruba , Khan Sara , Ukrani Janta , Zahid Ibrahim , Hassan Maryum , Jaglal Michael V. 
Published: December 2023

Introduction
CAR-T cell therapy, an FDA-approved breakthrough in hematologic malignancy treatment, has emerged as a game-changer through rigorous pivotal trials. Reportedly, women were underrepresented as authors in pivotal trials supporting approval of novel hematological drugs [1]. However, gender inequity in authorship across pivotal trials of FDA-approved novel CAR-T cell therapies remains unexamined. Thus, our study explores gender representation among authors in pivotal trials that led to the first-ever FDA approval of CAR-T cell therapies for hematological malignancies
Methods
Drugs@FDA portal was searched for novel CAR-T cell therapies approved between 2015 and 2022. Drug approval labels were searched to identify all pivotal trials listed in Section 14 under “Clinical Studies.” Only pivotal trials with corresponding trial publications were included in this study. The gender of trial authors was captured as binary (women and men) and was identified by using the Genderize software (Demografix ApS) or by verifying personal pronouns on authors' institutional profiles or other sources. Study-level estimates for the proportion of women authors were pooled using the DerSimonian and Laird random-effects meta-analysis of proportions model. Analyses were conducted with OpenMeta [Analyst] software version 10.12.
Results
From 2017-2022, the FDA approved a total of 6 novel CAR-T cell therapies, corresponding to 6 trials and 7 trial publications (755 participants) that were included in the study (Table 1). One trial's findings were reported in two distinct publications. A total of 201 authors were screened, and 1 was excluded because of the inability to assign author gender. Genderize was used to identify the gender of 177 authors; 152 were further confirmed by checking personal pronouns. Of the 24 authors with a prediction probability estimate less than 90.0% on Genderize, author gender was identified for 23 by using personal pronouns listed in institutional profiles or other sources.
The median number of men and women authors of trial publications was 19 (IQR, 15-23) and 9 (IQR, 6-11), respectively. The overall proportion of women authors was 29.6% (95% CI, 20.5%-38.7%). The proportion of women authors varied significantly across the 7 trial publications (p-heterogeneity = 0.043). The proportion of women as first and senior authors was the same, estimating about 14.3% (95% CI, 0.0%-40.2%).
Conclusions
Our study highlights gender disparities in the authorship of pivotal efficacy trials supporting the FDA approval of novel CAR-T cell therapies. This underscores the urgent need for institutions to devise tailored policies that tackle the unique challenges faced by women in the medical field, while fostering an inclusive and supportive workplace environment that empowers women to achieve academic success.