bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic kidney disease in Kuwait: a multicenter study of two cohorts with different levels of access to public healthcare
Authors: AlSahow Ali , AlYousef Anas , AlSabti Nasser , AlHelal Bassam , AlRajab Heba , AlQallaf Ahmed , Bahbahani Yousif , AlKandari Abdulrahman , Mazroue Ahmad , Dewidar Noha , Nessim Gamal , Mekky Ahmad Atef , Sherif Mohamed , Zamel Hesham , Abdalla Ahmed , Kumar Rajeev 
Published: October 2024

Abstract
Introduction
Kuwait has a large expatriate community who experience both restricted access to public health services and lower income than Kuwaiti citizens. Given these conditions, we examined differences in characteristics and management of chronic kidney disease (CKD) between Kuwaitis and expatriates.

Methods
Clinical and laboratory data for adult CKD Stages 3–5 not on dialysis (CKD 3–5 ND) patients with native kidneys attending nephrology clinics in all Ministry of Health hospitals collected from January 1, 2022, to December 31, 2022. Cohort was then divided into Kuwaiti patients and expatriates patients for comparison.

Results
We collected data from 2,610 patients (eGFR: 30.8 ml/min/1.73m2; age: 62.6 years; males: 56.7%; Kuwaitis: 62.1%). Kuwaitis were older (63.94 vs. 60.3 years, p < 0.001), with lower mean eGFR (30.4 vs. 31.5 ml/min/1.73m2, p = 0.052) than non-Kuwaitis, however, Kuwaitis had lower mean blood pressure (137.2/76.5 vs. 139.1/78.9 mmHg, p = 0.006), lower HbA1c in diabetics (7.59 vs. 7.82%, p = 0.010), and better lipid profile despite higher body mass indexes (29.6 vs. 28.9 kg/m2, p = 0.002). Both groups had high diabetes mellitus and hypertension rates. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) were used in only 22.6% and renin-angiotensin-aldosterone system inhibitors (RAASi) in only 46.2%.

Conclusion
CKD 3–5 ND is caused by diabetes mellitus in 56.6% of cases, and the majority have hypertension. In our study, non-Kuwaitis had higher eGFR; however, restricted public healthcare access and lower income can lead to an unhealthy diet and suboptimal care, which may cause higher blood pressure, higher HbA1c, and a higher dyslipidemia rate. RAASi and SGLT2i utilization must increase to combat CKD, and antihypertensive selection must improve.
The impact of physical activity on progression-free and overall survival in metastatic breast cancer based on molecular subtype
Authors: Ziegler Philipp , Hartkopf Andreas D. , Wallwiener Markus , Häberle Lothar , Kolberg Hans-Christian , Hadji Peyman , Tesch Hans , Ettl Johannes , Lüftner Diana , Müller Volkmar , Michel Laura L. , Belleville Erik , Wimberger Pauline , Hielscher Carsten , Huebner Hanna , Uhrig Sabrina , Wurmthaler Lena A. , Hack Carolin C. , Mundhenke Christoph , Kurbacher Christian , Fasching Peter A. , Wuerstlein Rachel , Untch Michael , Janni Wolfgang , Taran Florin-Andrei , Lux Michael P. , Wallwiener Diethelm , Brucker Sara Y. , Fehm Tanja N. , Schneeweiss Andreas , Goossens Chloë 
Published: October 2024

Abstract
Background
Although adequate physical activity has been shown to be beneficial in early breast cancer, evidence in metastatic breast cancer is sparse and contradictory, which could be related to distinct effects of physical activity on the different molecular cancer subtypes. Therefore, we here evaluated the effect of physical activity on progression-free and overall survival (PFS, OS) in metastatic breast cancer, specifically looking at molecular subtypes.

Methods
International Physical Activity Questionnaire (IPAQ) questionnaires, filled out by patients enrolled in the prospective PRAEGNANT registry (NCT02338167; n = 1,270) were used to calculate metabolic equivalent task (MET) minutes, which were subsequently categorized into low (n = 138), moderate (n = 995) or high IPAQ categories (n = 137). Cox regression analyses were used to evaluate the impact of IPAQ categories and its interaction with molecular subtypes on PFS and OS.

Results
Patient and tumor characteristics were equally distributed across IPAQ categories. HER2pos, HRpos and TNBC were present in 23.1%, 65.7% and 11.2% of patients, respectively. IPAQ scores did not have an impact on PFS and OS in addition to established prognostic factors, either overall or in particular molecular subtypes (PFS: p = 0.33 and OS: p = 0.08, likelihood ratio test). Exploratory analyses showed higher overall survival rates for high IPAQ categories compared to low/moderate IPAQ categories in luminal B-like breast cancer.

Conclusions
Self-reported physical activity using the IPAQ questionnaire did not significantly affect PFS or OS in patients suffering from metastatic breast cancer. Nevertheless, some hypothesis-generating differences between molecular subtypes could be observed, which may be interesting to evaluate further.
Exploring the prevalence of chlamydial and gonorrheal infections in pregnant women: a multicenter study in Egypt
Authors: El-Gibaly Omaima , Wahba Momdouh , Gamaleldin Nahla , Hashish Alaa , Ibrahim Mostafa Nasr , Khalifa Ahmed Khedr , Mohammed Sherif Yehia , wasfy Mohamed Ahmed , Eldosky Sara Ali Mohammed , Amin Wagdy , Elsayed Heba , Amin Mariam Taher 
Published: October 2024

Abstract
Background
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widespread, treatable sexually transmitted infections (STIs) of global significance, affecting millions annually. Left untreated, they pose significant risks, including pelvic inflammatory disease (PID), infertility, and complications during pregnancy. The U.S. Centers for Disease Control recommends annual chlamydial screening for sexually active women to address these risks. Responding to this global challenge, the World Health Organization (WHO) has formulated a global health sector strategy on sexually transmitted infections, outlining priority actions to strengthen STI responses in countries. However, STI epidemiological studies encounter challenges in developing nations like Egypt due to socio-cultural factors, poverty, and limited diagnostic facilities. In Egypt, STI diagnosis primarily relies on clinical presentations, lacking structured screening programs for CT and NG. This study’s main objective is to estimate the prevalence of Chlamydial and gonorrheal infections, advocating for supportive STI strategies in Egypt. Additionally, the study aims to provide a foundation for national prevalence estimates of CT and NG infections.

Methods
A cross-sectional study encompassed five antenatal clinics in different regions of Egypt. A total of 1040 pregnant women attending these clinics were consecutively sampled. Data collection involved structured questionnaires, and urine samples were subjected to the GeneXpert CT/NG qualitative real-time PCR test.

Results
The prevalence of CT infections was 0.29% (95% CI, 0.10–0.86%), with no detected NG infections. The three CT-positive cases were distributed across different recruitment centers, with no statistically significant differences observed between infected and non-infected participants. Notably, 40.3% of recruited women reported gynecological symptoms, primarily discharge. Additionally, 9.6% had undergone previous testing for sexually transmitted infections, with 8.2% receiving positive results.

Conclusions
This study provides valuable data on the prevalence of CT and NG infections among pregnant women attending ANC clinics in Egypt. The findings underscore the importance of ongoing surveillance, routine screening, and targeted interventions to ensure the reproductive health and well-being of pregnant women and their infants. Further research is warranted to explore the broader implications of STIs in different populations and to inform evidence-based guidelines for screening and management in diverse settings. Trial registration: IRB no.: 17,400,017; WHO ERC Protocol Id. A66005.
The questions on violence (FOV) tool for interpersonal violence inquiry in Swedish healthcare settings – evaluation of content validity, face validity and test-retest reliability
Authors: Lövestad Solveig , Sjöström Karin , Björk Josefin , Örmon Karin 
Published: October 2024

Abstract

Background
Previous research indicates that routine inquiry or screening conducted by healthcare providers may significantly increase the identification of interpersonal violence. There is a lack of comprehensive instruments to routinely assess patients about interpersonal violence and violence against children in the household. The purpose of this study was to assess the content validity, face validity and reliability of the Questions on Violence (FOV) tool, an instrument specifically designed for routine inquiries about interpersonal violence in healthcare settings within the Swedish context.

Methods
The content validity, face validity and reliability of the FOV instrument was assessed through (1) a content validity index with six experts in the field of intimate partner violence, (2) cognitive interviews with nine patients recruited from a primary healthcare facility, and (3) an evaluation of the test-retest reliability based on responses from 37(50.0%) university students. The intraclass correlation coefficient, model 2.1, was calculated to assess the degree of correlation and agreement between the two measurements.

Results
Calculations based on the content validity index indicated that five out of seven items had excellent content validity (≥ 0.78). The average content validity index of included items was 0.88, which is slightly below the recommended threshold for excellent content validity. The results based on the cognitive interviews revealed that participants found the seven items to be relevant and easy to understand. Overall, the participants agreed that the concept of ‘close relationships’ primarily encompassed intimate partners, family members, and close friends. The value of the intraclass correlation coefficient was 0.85 (0.77–0.91; CI 95%), indicating good reliability with an interval of good to excellent test-retest reliability.

Conclusions
The results demonstrate that the seven-item FOV instrument has good content and face validity as well as good to excellent test-retest reliability. The current study provides healthcare professionals with a short yet comprehensive instrument for identifying patients who have experienced or perpetrated different forms of interpersonal violence.
Sex disparities in the prevalence, incidence, and management of diabetes mellitus: an Australian retrospective primary healthcare study involving 668,891 individuals
Authors: Mnatzaganian George , Lee Crystal Man Ying , Cowen Gill , Boyd James H. , Varhol Richard J. , Randall Sean , Robinson Suzanne 
Published: October 2024

Abstract
Background
In Australia, diabetes is the fastest growing chronic condition, with prevalence trebling over the past three decades. Despite reported sex differences in diabetes outcomes, disparities in management and health targets remain unclear. This population-based retrospective study used MedicineInsight primary healthcare data to investigate sex differences in diabetes prevalence, incidence, management, and achievement of health targets.

Methods
Adults (aged ≥ 18 years) attending 39 general practices in Western Australia were included. Diabetes incidence and prevalence were estimated by age category. Health targets assessed included body mass index (BMI), blood pressure, blood lipids, and glycated haemoglobin (HbA1c) levels. Medical management of diabetes-associated conditions was also investigated. Time-to-incident diabetes was modelled using a Weibull regression. A multilevel mixed-effects logistic regression model investigated risk-adjusted sex differences in achieving the HbA1c health target (HbA1c ≤ 7.0% (≤ 53 mmol/mol)).

Results
Records of 668,891 individuals (53.4% women) were analysed. Diabetes prevalence ranged from 1.3% (95% confidence interval (CI) 1.2%-1.3%) in those aged < 50 years to 7.2% (95% CI 7.1%-7.3%) in those aged ≥ 50 years and was overall higher in men. In patients younger than 30 years, incidence was higher in women, with this reversing after the age of 50. Among patients with diabetes, BMI ≥ 35 kg/m2 was more prevalent in women, whereas current and past smoking were more common in men. Women were less likely than men to achieve lipid health targets and less likely to receive prescriptions for lipid, blood pressure, or glucose-lowering agents. Men with incident diabetes were 21% less likely than women to meet the HbA1c target. Similarly, ever recorded retinopathy, nephropathy, neuropathy, hypertension, dyslipidaemia, coronary heart disease, heart failure, peripheral vascular disease and peripheral artery disease were higher in men than women.

Conclusions
This research underscores variations in diabetes epidemiology and management based on sex. Tailoring diabetes management should consider the patient's sex.
Effect of screw insertion depth into fractured vertebrae in the treatment of thoracolumbar fractures
Authors: Wang Jinghuai , Ren Dong , Geng Lindan , Chen Yufeng , Yao Shuangquan , Wang Pengcheng 
Published: October 2024

Abstract
Purpose
The study’s objective was to assess the effect of the screw insertion depth into fractured vertebrae in treating thoracolumbar fractures.

Materials and methods
This was a retrospective analysis of 92 patients with thoracolumbar fractures from December 2018 to February 2020. Patients had AO type A2, A3 thoracolumbar fractures. The patients were divided into two groups according to the screw insertion depth. The vertebral wedge angle (VWA), Cobb angle (CA), anterior vertebral body height (AVBH), middle vertebral body height (MVBH), visual analog scale (VAS) score, and Oswestry Disability Index (ODI) were compared preoperatively and at one week and 12 months postoperatively. The correlation between Vertebral height loss and potential risk factors, such as sex, age, BMD and BMI was evaluated.

Results
Compared with the preoperative data, the postoperative clinical and radiographic findings were significantly different in both groups, But no significant difference between the two groups at 1 week. At 1 year postoperatively, there was a significant difference in the CA (p < 0.0001), VWA (p = 0.047), AVBH (p < 0.0001), MVBH (p < 0.0001), VAS score (p < 0.0001), and ODI (p < 0.0001) between the two groups, Except for age, bone density and other influencing factors the long screw group had better treatment results than the short screw group.

Conclusion
A longer screw provides greater grip on the fractured vertebral body and stronger support to the vertebral plate. The optimal screw placement depth exceeds 60% of the vertebral body length on the lateral view.
Demographic and genetic impacts of powdery mildew in a young oak (Quercus robur L.) cohort
Authors: Barrès Benoit , Dutech Cyril , Saint-Jean Gilles , Bodénès Catherine , Burban Christian , Fiévet Virgil , Lepoittevin Camille , Garnier-Géré Pauline , Desprez-Loustau Marie-Laure 
Published: October 2024

Abstract
Key message
By monitoring a field experiment over nine years, we investigated the impacts of the two main pathogen species Erysiphe quercicola S. Takam. and U. Braun and Erysiphe alphitoides (Griffon and Maubl.) U. Braun and S. Takam causing powdery mildew on a young cohort of pedunculate oak (Quercus robur L.), both from a demographic and genetic point of view using SNP markers. We show that survival rate is affected by mean disease severity. But while the growth-related tolerance to infection of the oak individual seems to be more determinant than resistance against infection, no equalizing effect of the disease could be detected.

Context
Studies on the effects of pathogens on the survival and population dynamics of forest trees are scarce. Yet a better understanding of these interactions could prove strategic in the challenging context of climate change.

Aims
Our general objective was to characterize the demographic and genetic impact of the two main pathogen species Erysiphe quercicola S. Takam. and U. Braun and Erysiphe alphitoides (Griffon and Maubl.) U. Braun and S. Takam causing powdery mildew in the early stages of a Quercus robur L. population.

Methods
An ad hoc field design with two disease exposures, natural and protected, was surveyed over nine years. This enabled a detailed phenotypic monitoring of 1733 emerging individuals from 15 progenies, and the genotyping of 68% of them.

Results
The pathogen induced high levels of seedling mortality several years after sowing, associated with reduced growth and capacity to overwinter. Fast-growing families showed the highest survival rate under both natural and protected disease exposure. Contrary to a possible trade-off hypothesis between growth and defense, family height potential was not negatively related to disease resistance across the studied oak mother trees. While supporting a deleterious effect of very low individual heterozygosity on the probability of survival, average genomic diversity was not significantly affected by mortality associated with powdery mildew. Our study also points to a few candidate genes for several fitness-related traits.

Conclusion
Overall, our results suggest that in oak natural populations, infection levels (related to resistance sensu stricto) may be less determinant than growth-related tolerance to infection for the fate of seedlings. However, an equalizing effect of powdery mildew on relative oak genotype performances cannot be excluded at later stages.
Early metabolic and hemodynamic indicators of kidney dysfunction in mice offspring from parental low protein diet
Authors: Diniz Fabiola , Edgington-Giordano Francesca , El-Dahr Samir S. , Tortelote Giovane G. 
Published: October 2024

Abstract
Background
Parental malnutrition, particularly a low-protein diet (LPD), causes oligonephropathy at birth and predisposes offspring to hypertension and chronic kidney disease later in life. The onset of adult kidney disease varies based on genetics and environmental factors, often with subclinical alterations in kidney function being overlooked. This study aimed to examine changes in kidney morphology before significant kidney function decline in the offspring of mice fed a low-protein diet.

Methods
Using a combination of histological analysis, kidney metabolic and hemodynamic panel assessments, and advanced statistical techniques such as Linear Discriminant Analysis (LDA) and Principal Component Analysis (PCA), we investigated the initial impact of a maternal low-protein diet (LPD) on kidney development and function. Our study utilized 12-week-old F1 mice from F0 parents fed either a low-protein diet (LPD) or a normal-protein diet (NPD) before the onset of hypertension.

Results
The offspring (F1 generation) of parents (F0 generation) fed an LPD show reduced body weight from birth to P20. The kidney weight was also reduced compared to F1 offspring from parents fed an NPD. At 12 weeks of age, body weight normalized, but kidney weight remained low. Offspring of parents fed an LPD displayed abnormal kidney morphology, including dilated tubules, oligonephropathy, and fluid-filled cysts which had worsened with age. A kidney metabolic panel analysis at 12 weeks revealed a slight but consistent increase in urine albumin, plasma creatinine, mean urea, and BUN concentrations. Although no significant changes in hemodynamic variables were observed, 2/12 mice, both males, showed alterations in systolic blood pressure, suggesting sex-specific effects when comparing F1 mice from F0 fed either diet. Overall, kidney metabolic changes were strongly correlated to parental LPD.

Conclusion
Our findings indicate that significant kidney damage must accumulate in the F1 generation from parents fed an LPD before any detectable changes in blood pressure occur. Our study suggests that small variations in kidney metabolic function may point to early kidney damage and should not be overlooked in the offspring of these malnourished mice and likely humans.
Artificial intelligence in higher education: exploring faculty use, self-efficacy, distinct profiles, and professional development needs
Authors: Mah Dana-Kristin , Groß Nele 
Published: October 2024

AbstractFaculty perspectives on the use of artificial intelligence (AI) in higher education are crucial for AI’s meaningful integration into teaching and learning, yet research is scarce. This paper presents a study designed to gain insight into faculty members’ (N = 122) AI self-efficacy and distinct latent profiles, perceived benefits, challenges, use, and professional development needs related to AI. The respondents saw greater equity in education as AI’s greatest benefit, while students and faculty members’ lack of AI literacy was among the greatest challenges, with the majority interested in professional development. Latent class analysis revealed four distinct faculty member profiles: optimistic, critical, critically reflected, and neutral. The optimistic profile moderates the relationship between self-efficacy and usage. The development of adequate support services is suggested for successful and sustainable digital transformation.
The patient-reported outcome measure for older people living with frailty receiving acute care (PROM-OPAC): field-testing and validation
Authors: van Oppen James D. , Conroy Simon P. , Lalseta Jagruti , Mackintosh Nicola , Riley Peter , Richardson Vivien , Valderas Jose M. , Coats Timothy J. 
Published: October 2024

Abstract
Background
Current acute healthcare service metrics are not meaningful for older people living with frailty. Healthcare knowledge, situational security, and physical and psychosocial function are important outcomes typically not collected. The use of patient-reported outcome measures (PROMs) could support these assessments. Existing instruments are not comprehensive as they typically consider function, while older people with frailty also value enablement (self-determination and security in health and healthcare). This study field-tested and validated a PROM for older people with frailty receiving acute care (PROM-OPAC) to measure enablement.

Methods
People aged 65+ with Clinical Frailty Scale 5–8 were recruited within seventy-two hours of an emergency attendance. Iterations of the novel instrument were administered over three stages: (1) preliminary field-testing for reliability (response distribution and internal consistency) and structure (exploratory factor analysis, EFA); (2) intermediate field-testing of an improved instrument for reliability and structure; (3) final draft validation assessing reliability, structure (confirmatory factor analysis, CFA), and construct validity based on a priori hypotheses. Feasibility was appraised throughout using data completeness and response rates and times.

Results
241 people participated. Three items of a preliminary seven-item measure had poor response distribution or loading and were accordingly improved. The intermediate instrument had interpretability issues and three items required further improvement. The final eight-item draft had acceptable reliability (Cronbach’s alpha: 0.71), structure (two factors for self-determination and security; RMSEA: 0.065; TLI: 0.917; CFI: 0.944), and construct validity (lower scores from respondents waiting longer and requiring admission). Feasibility was promising (response rate 39%; 98% responses complete; median completion time 11 (IQR: 12) minutes).

Conclusions
Administration of the PROM-OPAC appeared feasible and the instrument had acceptable psychometric properties. Further evaluation is required to assess generalisability.