bluuebunny/crossref_metadata_2025_split huggingface dataset:
The descriptive analysis of depressive symptoms and White Blood Cell (WBC) count between the sexual minorities and heterosexual identifying individuals in a nationally representative sample: 2005–2014
Authors: Lu Junjie , Yang Jiarui , Liang Jingyang , Mischoulon David , Nyer Maren 
Published: February 2023

AbstractBackgroundSexual minorities are at a higher risk of suffering from depressive symptoms compared with heterosexual individuals. Only a few studies have examined the conditions of having depressive symptoms within different sexual minority groups, especially people with sexual orientation uncertainty in a nationally representative sample. Furthermore, few studies have explored whether the mean white blood count (WBC) is different between people with and without depressive symptoms among different sexual minority groups in a nationally representative sample.MethodsWe analyzed the National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2014 with a sample of 14,090 subjects. We compared the prevalence of depressive symptoms in subpopulations stratified by sex, sexual minority status, and race. We also examined the difference in mean WBC count between depressed and non-depressed people among heterosexual individuals and different sexual minority groups. Additionally, two multivariable logistic regression models were used to explore the association between sexual minority status and depressive symptoms, treating sexual minority status as both a binary and categorical variable.ResultsFemale sex (OR: 1.96, 95% CI: 1.72—2.22) and sexual minority status (OR: 1.79, 95% CI: 1.47—2.17) were both independently associated with depressive symptoms. Within the sexual minority population, subjects who were unsure about their sexual identities had the highest odds of having depressive symptoms (OR: 2.56, 95% CI: 1.40—4.68). In the subgroup analysis considering intersectionality, black sexual minority females had the highest rate of depressive symptoms (19.4%, 95% CI: 7.72—40.98). Finally, the mean WBC count differed significantly between people with and without depressive symptoms among male heterosexual individuals, female heterosexual individuals, and female sexual minorities, but not among male sexual minorities.ConclusionsBased on sex, race, and sexual minority status, black females of sexual minority status had the highest rate of depressive symptoms. Within sexual minority groups, participants who were unsure about their sexual identities had the highest odds of having depressive symptoms. Finally, the mean WBC count was significantly higher among people with depressive symptoms than those without depressive symptoms only among male heterosexuals, female heterosexuals, and female sexual minorities, but not among male sexual minorities. Future research should investigate the social and biological mechanisms of the differences.
What matters in development and sustainment of community dementia friendly initiatives and why? A realist multiple case study
Authors: Thijssen Marjolein , Kuijer-Siebelink Wietske , Lexis Monique A.S. , Nijhuis-van der Sanden Maria W. G. , Daniels Ramon , Graff Maud 
Published: February 2023

Abstract
Background
Dementia friendly communities (DFCs) are seen as key to participation of people with dementia and carers. Dementia-friendly initiatives (DFI) are important building blocks for the growth of DFCs. Therefore, it is essential to understand how DFIs are developed and sustained to secure the growth of DFCs. This study identifies contextual factors and mechanisms that influence the development and sustainment of Dutch DFIs. It also explains how these contextual factors and mechanisms are interrelated and the outcomes to which they lead.

Methods
Mixed methods, namely interviews, observations, documentation and focus groups, were used for this realist multiple case study. Participants were professionals (n = 46), volunteers (n = 20), people with dementia (n = 1) and carers (n = 2) who were involved in development and sustainment of DFIs in four Dutch DFCs.

Results
This study revealed three middle-range program theories as final outcomes: development of a support base, collaboration, and participation in DFIs by people with dementia and carers. These theories address institutional, organisational, interpersonal and individual levels in the community that are essential in development and sustainment of DFIs.

Conclusions
The development and sustainment of DFIs requires the development of a support base, collaboration, and participation in DFIs by people with dementia and their carers.
Migrant and native women’s perceptions of prenatal care communication quality: the role of host-country language proficiency
Authors: Hamwi Sousan , Lorthe Elsa , Severo Milton , Barros Henrique 
Published: February 2023

Abstract
Background
Despite the potentially significant impact of women-prenatal care provider communication quality (WPCQ) on women’s perinatal health, evidence on the determinants of those perceptions is still lacking, particularly among migrant women.

Methods
We aimed to examine the effect of women’s host-country language proficiency on their perceived WPCQ. We analyzed the data of 1210 migrant and 1400 native women who gave birth at Portuguese public hospitals between 2017 and 2019 and participated in the baMBINO cohort study. Migrants’ language proficiency was self-rated. Perceived WPCQ was measured as a composite score of 9 different aspects of self-reported communication quality and ranged from 0 (optimal) to 27.

Results
A high percentage of women (29%) rated communication quality as “optimal”. Zero-inflated regression models were fitted to estimate the association between language proficiency and perceived WPCQ. Women with full (aIRR 1.35; 95% CI 1.22,1.50), intermediate (aIRR 1.41; 95% CI 1.23,1.61), and limited (aIRR 1.72; 95% CI 1.45,2.05) language proficiencies were increasingly more likely to have lower WPCQ when compared to natives.

Conclusions
Facilitating communication with migrant women experiencing language barriers in prenatal care could provide an important contribution to improving prenatal care quality and addressing potential subsequent disparities in perinatal health outcomes.
What is the role of attitudinal barriers on cervical cancer screening non-attendance? Findings from a cross-sectional study with migrant women in Portugal
Authors: Marques Patrícia , Geraldes Mariana , Gama Ana , Heleno Bruno , Dias Sónia 
Published: February 2023

Abstract
Background
Cervical cancer is a common disease which can be effectively and timely detected by cervical cancer screening. However, access to cervical cancer screening is unequal, and it is known that migrant women have a lower attendance to cervical cancer screening. These inequalities are associated with several factors, including attitudes and beliefs of the women regarding screening practices, which prevents them from participating. This study aims to explore the attitudinal barriers to cervical cancer screening among migrant women in Portugal.

Methods
A web-based cross-sectional survey was conducted with 1100 migrant women residing in Portugal. Women were recruited through social media platforms. The survey included items on socioeconomic characteristics, cervical cancer screening history and an 11-item attitudinal questionnaire to assess attitudinal barriers. Logistic regression models were used for statistical analysis.

Results
The attitudinal barriers to CCS most often reported by participants were fear of the test result (25.3%), worry about seeing a male health professional (23.8%), perceiving the test as painful (23.1%), embarrassment (18.5%), difficulties scheduling the test (14.3%), and having a negative experience in screening (12.4%). Low perceived need in absence of symptoms and lack of motivation to be screened were reported by less than 5% of the women. However, the results suggest that most of the attitudinal barriers with higher agreement percentage have no association with cervical cancer screening attendance. Among all the attitudinal barriers, low perceived need of screening and lack of motivation were associated with CCS non-attendance.

Conclusions
Based on the findings, out of all the factors analyzed, low perceived need of screening and lack of motivation are the most relevant factors associated with non-attendance among migrants in Portugal. Promoting health literacy and empowering women with knowledge about benefits of screening may help overcoming these barriers. Therefore, this study provides a foundation for stakeholders on which areas should be prioritized when developing strategies aiming to reduced cervical cancer screening non-attendance among migrant women.
Time and productivity loss associated with immunotherapy infusions for the treatment of melanoma in the United States: a survey of health care professionals and patients
Authors: Aguiar-Ibáñez Raquel , Scherrer Emilie , Grebennik Dmitri , Cook John , Bagga Shalini , Sawhney Baanie , Khandelwal Anvi , Soefje Scott A. 
Published: February 2023

Abstract
Introduction
A new dosing schedule for the oncology immunotherapy pembrolizumab, every 6 weeks (Q6W), has been approved by the U.S. FDA, reducing the frequency of visits to infusion centers. We quantified the time spent by oncologists, nurses, patients, and caregivers per melanoma-related immunotherapy infusion visit to evaluate its potential impact.

Methods
Surveys were self-completed by 100 oncologists, 101 oncology nurses, and 100 patients with melanoma across the U.S. to quantify the time spent per infusion visit with pembrolizumab (Q3W or Q6W), nivolumab (Q2W or Q4W), or nivolumab+ipilimumab (nivolumab in combination: Q3W; nivolumab maintenance: Q2W or Q4W). Time measures included traveling, waiting, consultation, infusion, post-treatment observation, and caregiving. Respondents were also surveyed regarding the impact of the COVID-19 pandemic on infusion treatments.

Results
Responses deemed valid were provided by 89 oncologists, 93 nurses, and 100 patients. For each new [returning] patient treated with pembrolizumab, nivolumab or nivolumab+ipilimumab, oncologists reported to spend an average of 90 [64], 87 [60] and 101 [69] minutes per infusion visit (p-value for between-group difference = 0.300 [0.627]). For first [subsequent] treatment cycles, nurses reported spending 160 [145] average minutes per visit for nivolumab+ipilimumab, versus roughly 120 [110] for the single agents (p-value for between-group difference = 0.018 [0.022]). Patients reported to spend an average of 263, 382, and 224 minutes per visit at the center for pembrolizumab (N = 47), nivolumab (n = 34), and nivolumab+ipilimumab (n = 15) respectively (p-value for between-group difference = 0.0002). Patients also reported that their unpaid (N = 20) and paid caregivers (N = 41) spent with them an average of 966 and 333 minutes, respectively, from the day before to the day after the infusion visit.

Conclusion
Less frequent immunotherapy infusion visits may result in substantial time savings for oncologists, nurses, patients, and caregivers.
Evaluation of an infection control link nurse program: an analysis using the RE-AIM framework
Authors: Dekker Mireille , Jongerden Irene P. , Caris Martine G. , de Bruijne Martine C. , Vandenbroucke-Grauls Christina M. J. E. , van Mansfeld Rosa 
Published: February 2023

AbstractBackgroundImportant elements of programs that train and support infection control link nurses (ICLN) are the engagement of stakeholders, support from hospital and ward management and a structure for iterative improvement. The effects of programs, that combine all these elements, are unknown. We evaluated such a comprehensive program to explore its impact on link nurses and infection prevention practices and routines.MethodsWe used the RE-AIM framework, a robust, evidence-based framework within the field of Implementation Science, to evaluate the impact of our ICLN training and support program. We used a mixed methods approach and organized the outcomes along its five dimensions: Reach, Effectiveness, Adoption, Implementation and Maintenance.ResultsBetween 2014 and 2018, on average 91% of the inpatient wards and 58% of the outpatient clinics participated in the program (Reach) and impacted guideline adherence in inpatient wards. Link nurses felt engaged and empowered, and perceived their contribution to these results as pivotal. Ward managers confirmed the value of ICLN to help with implementing IPC practices (Effectiveness). The program was adopted both at the hospital and at the ward level (Adoption). Based on ongoing evaluations, the program was adapted by refining education, training and support strategies with emphasis on ward specific aspects (Implementation). The ICLN program was described as a key component of the infection prevention policy to sustain its effects (Maintenance).ConclusionsOur infection control link nurse program helped ICLN to improve infection prevention practices, especially in inpatient wards. The key to these improvements lay within the adaptability of our link nurse program. The adjustments to the program led to a shift of focus from hospital goals to goals tailored to the ward level. It allowed us to tailor activities to align them with the needs specific to each ward.
Prenatal exposure to fine particulate matter and newborn anogenital distance: a prospective cohort study
Authors: Shen Xiaoli , Meng Xia , Wang Cuiping , Chen Xiangfeng , Chen Qian , Cai Jing , Zhang Jun , Zhang Qianlong , Fan Lichun 
Published: February 2023

Abstract
Background
Considerable attention has been paid to reproductive toxicity of fine particulate matter (PM2.5). However, the relationship between prenatal PM2.5 exposure and anogenital distance (AGD) has not been well studied. We aim to investigate the potential effects of prenatal exposure to PM2.5 on newborn AGD.

Methods
Prenatal PM2.5 exposure of 2332 participates in Shanghai (2013–2016) was estimated using high-performance machine learning models. Anoscrotal distance (AGDas) in male infants and anofourchette distance (AGDaf) in female infants were measured by well-trained examiners within 3 days after birth. We applied multiple linear regression models and multiple informant models to estimate the association between prenatal PM2.5 exposure and AGD.

Results
Multiple linear regression models showed that a 10 μg/m3 increase in PM2.5 exposure during full pregnancy, the second and third trimesters was inversely associated with AGDas (adjusted beta = − 1.76, 95% CI: − 2.21, − 1.31; − 0.73, 95% CI: − 1.06, − 0.40; and − 0.52; 95% CI: − 0.87, − 0.18, respectively) in males. A 10 μg/m3 increase in PM2.5 exposure during the full pregnancy, the first, second, and third trimesters was inversely associated with AGDaf (adjusted beta = − 4.55; 95% CI: − 5.18, − 3.92; − 0.78; 95% CI: − 1.10, − 0.46; − 1.11; 95% CI: − 1.46, − 0.77; − 1.45; 95% CI: − 1.78, − 1.12, respectively) in females after adjusting for potential confounders. Multiple informant models showed consistent but slightly attenuated associations.

Conclusion
Our study observed a significant association between gestational PM2.5 exposure during pregnancy and shortened AGD in newborns, and provided new evidence on potential reproductive toxicity of prenatal PM2.5 exposure.
Near-infrared light triggered in situ release of CO for enhanced therapy of glioblastoma
Authors: Ge Juan , Zuo Miaomiao , Wang Qirong , Li Zhen 
Published: February 2023

Abstract

Background
Photodynamic therapy (PDT) features high biocompatibility and high spatiotemporal selectivity, showing a great potential in glioblastoma (GBM) treatment. However, its application was restricted by the poor therapeutic efficacy and side effect.

Results
In this study, a therapeutic nanoplatform (UCNPs@Ce6/3HBQ@CM) with combination of PDT and CO therapy was constructed, in which a photoCORM and a photosensitizer were loaded onto the surface of upconversion nanoparticles (UCNPs) functioning as photon transducer. Benefitting from NIR excitation and multicolor emission of UCNPs, the penetration depth of excitation light is enhanced and meanwhile simultaneous generation of CO and ROS in tumor site can be achieved. The as-prepared nanocomposite possessed an elevated therapeutic efficiency with the assistance of CO through influencing mitochondrial respiration and depleting ATP, accompanying with the reduced inflammatory responses. By wrapping a homologous cell membrane, the nanocomposite can target GBM and accumulate in the tumor site, affording a powerful tool for precise and efficient treatment of GBM.

Conclusion
This therapeutic nanoplatform UCNPs@Ce6/3HBQ@CM, which combines PDT and CO therapy enables precise and efficient treatment of refractory glioblastoma.
Biomimetic retractable DNA nanocarrier with sensitive responsivity for efficient drug delivery and enhanced photothermal therapy
Authors: Yang Yuanhuan , Cai Xueting , Shi Menglin , Zhang Xiaobo , Pan Yang , Zhang Yue , Ju Huangxian , Cao Peng 
Published: February 2023

Abstract
Background
The coalition of DNA nanotechnology with diversiform inorganic nanoparticles offers powerful tools for the design and construction of stimuli-responsive drug delivery systems with spatiotemporal controllability, but it remains challenging to achieve high-density oligonucleotides modification close to inorganic nanocores for their sensitive responsivity to optical or thermal signals.

Results
Inspired by Actinia with retractable tentacles, here we design an artificial nano-Actinia consisted of collapsible DNA architectures attached on gold nanoparticle (AuNP) for efficient drug delivery and enhanced photothermal therapy. The collapsible spheroidal architectures are formed by the hybridization of long DNA strand produced in situ through rolling circle amplification with bundling DNA strands, and contain numerous double-helical segments for the intercalative binding of quercetin as the anti-cancer drug. Under 800-nm light irradiation, the photothermal conversion of AuNPs induces intensive localized heating, which unwinds the double helixes and leads to the disassembly of DNA nanospheres on the surface of AuNPs. The consequently released quercetin can inhibit the expression of heat shock protein 27 and decrease the thermal resistance of tumor cells, thus enhancing photothermal therapy efficacy.

Conclusions
By combining the deformable DNA nanostructures with gold nanocores, this Actinia-mimetic nanocarrier presents a promising tool for the development of DNA-AuNPs complex and opens a new horizon for the stimuli-responsive drug delivery.

Graphical Abstract
Melatonin and 5-fluorouracil combination chemotherapy: opportunities and efficacy in cancer therapy
Authors: Mafi Alireza , Rezaee Malihe , Hedayati Neda , Hogan Sara Diana , Reiter Russel J. , Aarabi Mohammad-Hossein , Asemi Zatollah 
Published: February 2023

AbstractCombined chemotherapy is a treatment method based on the simultaneous use of two or more therapeutic agents; it is frequently necessary to produce a more effective treatment for cancer patients. Such combined treatments often improve the outcomes over that of the monotherapy approach, as the drugs synergistically target critical cell signaling pathways or work independently at different oncostatic sites. A better prognosis has been reported in patients treated with combination therapy than in patients treated with single drug chemotherapy. In recent decades, 5-fluorouracil (5-FU) has become one of the most widely used chemotherapy agents in cancer treatment. This medication, which is soluble in water, is used as the first line of anti-neoplastic agent in the treatment of several cancer types including breast, head and neck, stomach and colon cancer. Within the last three decades, many studies have investigated melatonin as an anti-cancer agent; this molecule exhibits various functions in controlling the behavior of cancer cells, such as inhibiting cell growth, inducing apoptosis, and inhibiting invasion. The aim of this review is to comprehensively evaluate the role of melatonin as a complementary agent with 5-FU-based chemotherapy for cancers. Additionally, we identify the potential common signaling pathways by which melatonin and 5-FU interact to enhance the efficacy of the combined therapy.
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Targeting and regulation of autophagy in hepatocellular carcinoma: revisiting the molecular interactions and mechanisms for new therapy approaches
Authors: Hashemi Mehrdad , Nadafzadeh Niloufar , Imani Mohammad Hassan , Rajabi Romina , Ziaolhagh Setayesh , Bayanzadeh Seyedeh Delaram , Norouzi Raheleh , Rafiei Reihaneh , Koohpar Zeinab Khazaei , Raei Behnaz , Zandieh Mohammad Arad , Salimimoghadam Shokooh , Entezari Maliheh , Taheriazam Afshin , Alexiou Athanasios , Papadakis Marios , Tan Shing Cheng 
Published: February 2023

AbstractAutophagy is an evolutionarily conserved process that plays a role in regulating homeostasis under physiological conditions. However, dysregulation of autophagy is observed in the development of human diseases, especially cancer. Autophagy has reciprocal functions in cancer and may be responsible for either survival or death. Hepatocellular carcinoma (HCC) is one of the most lethal and common malignancies of the liver, and smoking, infection, and alcohol consumption can lead to its development. Genetic mutations and alterations in molecular processes can exacerbate the progression of HCC. The function of autophagy in HCC is controversial and may be both tumor suppressive and tumor promoting. Activation of autophagy may affect apoptosis in HCC and is a regulator of proliferation and glucose metabolism. Induction of autophagy may promote tumor metastasis via induction of EMT. In addition, autophagy is a regulator of stem cell formation in HCC, and pro-survival autophagy leads to cancer cell resistance to chemotherapy and radiotherapy. Targeting autophagy impairs growth and metastasis in HCC and improves tumor cell response to therapy. Of note, a large number of signaling pathways such as STAT3, Wnt, miRNAs, lncRNAs, and circRNAs regulate autophagy in HCC. Moreover, regulation of autophagy (induction or inhibition) by antitumor agents could be suggested for effective treatment of HCC. In this paper, we comprehensively review the role and mechanisms of autophagy in HCC and discuss the potential benefit of targeting this process in the treatment of the cancer.
Graphical abstract