bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and determinants of poor glycemic control among diabetic chronic kidney disease patients on maintenance hemodialysis in Tanzania
Authors: Mfundo Emmanuel Arthur , Marealle Alphonce Ignace , Nyondo Goodluck G. , Manguzu Martine A. , Buma Deus , Kunambi Peter , Mutagonda Ritah F. 
Published: February 2025

Background
Poor glycemic control in diabetic chronic kidney disease (CKD) patients on maintenance hemodialysis is of great challenge, resulting in increased risk of morbidity and mortality. This study aimed to determine the prevalence and determinants of poor glycemic control among diabetic CKD patients on maintenance hemodialysis.

Methodology
A cross-sectional study was conducted in 12 dialysis centers located in four regions of Tanzania from March to June 2023. The study population was diabetic CKD patients above 18 years on maintenance hemodialysis for three months or more. A consecutive sampling technique was used for patient recruitment, and a semi-structured questionnaire was used to collect data. The primary outcome was poor glycemic control were considered when glycated hemoglobin (HbA1c) levels were <  6% or > 8%. Statistical Package for Social Sciences (SPSS) version 23 was used for data analysis. Univariate and multivariable regression models were used to evaluate the determinants of poor glycemic control. A p-value < 0.05 was considered statistically significant.

Results
Out of 233 enrolled patients, the overall prevalence of poor glycemic control was 55.4%, whereby 27.0% had HbA1c < 6% and 28.33% had HbA1c > 8%. A high risk of HbA1c > 8% was observed among patients who were on antidiabetic medication (2.16 (95% CI: 1.06–4.41) p =  0.035) and those attending dialysis sessions less than 3 times a week (1.59 (95% CI: 1.02–2.48) p =  0.040). The lower risk of HbA1c < 6% was observed in patients dialyzed using glucose-containing dialysates than those dialyzed with glucose-free dialysate (0.57 (95% CI 0.36–0.87) p =  0.020).

Conclusion
The high prevalence of poor glycemic control among diabetic CKD patients, as revealed by this study, has significant implications. Patients on antidiabetic medication and those with less than three dialysis sessions per week are at a high risk of HbA1c > 8%. Conversely, patients dialyzed using glucose-free dialysates are at a high risk of HbA1c < 6%.
Glycemic control in diabetic chronic kidney disease (CKD) patients is a great challenge due to altered glucose homeostasis, gluconeogenesis, tubular glucose reabsorption and inaccuracy of glycemic regulation metrics [1]. Furthermore, changed renal pharmacokinetics of antihyperglycemic agents (AHA), uremic milieu, and dialysis therapy also contribute to this challenge [2]. Based on the severe risk of hyperglycemia and hypoglycemia in patients with diabetic end-stage renal disease (ESRD), glycemic control is of paramount importance.
The impact of Duration of Untreated Psychosis on functioning and quality of life over one year of Coordinated Specialty Care (CSC)
Authors: Hazan Hadar , Tayfur Sümeyra N. , Zhou Bin , Li Fangyong , Gibbs-Dean Toni , Karmani Sneha , Kline Emily , Ferrara Maria , Corbera Silvia , Riley Sarah , Yoviene Sykes Laura A. , Tek Cenk , Keshavan Matcheri S. , Srihari Vinod H. 
Published: February 2025

Background
This study examined the relationship between the Duration of Untreated Psychosis (DUP) and functional outcomes at baseline, 6 months, and 12 months after admission to Coordinated Specialty Care (CSC).

Methods
A total of 246 participants from two U.S. public-sector CSC programs were categorized into Low and High DUP groups using two criteria: (i) a median split of the DUP distribution and (ii) the World Health Organization (WHO) aspirational standard of 3 months. Changes in global functioning (GAF), social functioning (GF: Social), and occupational functioning (GF: Role), symptom severity (PANSS), and quality of life (QoL) were assessed using a Linear Mixed Model Repeated Measures (MMRM) analysis across the three time points. A Generalized Linear Model (GLM) with a logit link function was applied to analyze binary outcomes, specifically the status of being Neither in the Labor Force, Education, or Training (NLFET). Both models adjusted for time and site as covariates and used an unstructured variance-covariance matrix to account for within-subject correlations in repeated measures. The difference-in-differences method was employed to estimate the impact of DUP on outcomes over time, with results reported as least square means for continuous outcomes, odds ratios for binary outcomes, and 95% confidence intervals (CI) for both Low and High DUP groups.

Results
No significant differences were observed between the Low and High DUP groups at baseline. By 6 months, participants in the Low DUP group (DUP < 3 months) exhibited significantly greater improvements (reduction) in NLFET status (3-month OR = 3.25, p = 0.03; median split OR = 2.25, p = 0.03) and global functioning, GF: Role, and GF: Social. By 12 months, the Low DUP group continued to show significantly greater NLFET status improvement (3-month OR = 3.59, p = 0.03; median split OR = 3.40, p = 0.0032). Improvements in global functioning were sustained at 12 months, while social and occupational functioning gains were not. No significant differences were observed between groups for quality of life or symptom severity over time.

Conclusion
Shorter DUP is linked to more rapid functional recovery within the first year after CSC admission.
Patient perceived weight stigma and patient-centered language use preferences: A cross-sectional mixed methods analysis conducted in a large academic medical center
Authors: Kane Ryan M. , Williams Selvi B. , Reynolds Kimberly , Kincanon Abby , Hager Marcy R. , McDougall Craig , Purnell Jonathan Q. , Carney Patricia A. 
Published: February 2025

Background
Due to the rising prevalence of obesity and its impact on healthcare, patient-specific context is needed to optimize weight management with an emphasis on reducing health care-associated weight stigma. Our survey aimed to explore institution-specific patient experiences of weight stigma and preferences for patient-centered language use regarding weight management care.

Methods
This cross-sectional analysis adopted a concurrent mixed methods design with a sample of individuals who opted in to complete patient experience surveys after receiving care at a large academic medical center in the United States (U.S.). Categorical and continuous variables were assessed using Chi-squared and analysis of variance. We used classical content analysis to qualitatively analyze free-text data for thematic coding.

Results
After a 1-week survey fielding period, 3,219 of 16,758 patients completed the survey, yielding a response rate of (19.2%) with 2,816 having available electronic health record body mass index (BMI) data. Patients were comfortable discussing weight with their primary care providers but showed variation in the preferred approach and terms. Female patients with higher BMIs reported higher rates of delayed and canceled care due to prior weight stigma (25.6% and 12.2% for patients with class 3 obesity), and preferred a slower, gentler, and less direct approach with term preferences for “healthy eating plan” and against “obesity.” Qualitative analysis yielded 27 themes grouped into three domains: Emotional Hinderances, Perceptual Hinderances, and Perceived Helpfulness.

Conclusions
Findings from our large single institution cohort expand on the existing weight stigma literature by identifying patient language preferences and healthcare experiences according to patient weight class and sex. Given the potential impact of understanding context-specific patient language use preferences to reduce weight stigma, we recommend other healthcare systems use a similar process to address weight stigma as part of a coordinated health system improvement initiative to enhance patient-centered weight management care.
Type 1 diabetes incidence during COVID-19 pandemic has not been influenced by COVID-19 vaccination in northern Italy region, Lombardy
Authors: Mameli Chiara , Valsecchi Camilla , Cereda Danilo , Scarioni Simona , Barcellini Lucia , Boriello Catia , Bonfanti Riccardo , Brambilla Ilaria , Calcaterra Valeria , Calzi Elena , Cardani Roberta , Cogliardi Anna , Felappi Barbara , Florini Giorgia , Frontino Giulio , Guerraggio Lucia Paola , Hajro Adelina , Macedoni Maddalena , Macellaro Patrizia , Petitti Agnese , Pistone Carmelo , Provero Cristina , Radaelli Silvia , Redaelli Francesca Chiara , Rigamonti Andrea , Scaramuzza Andrea , Sordelli Silvia , Spiri Daniele , Pelliccia Ciretta , Zampolli Maria , Zuccotti Gian Vincenzo 
Published: February 2025

Objective
To describe the trends of type 1 diabetes(T1D) incidence in 0–17-year-olds over the years 2020–2023, and the COVID-19 vaccination uptake in Lombardy region.

Methods
Data about children and adolescents aged 0–17 years who received a diagnosis of T1D from 2020 to 2023 were extracted from the public computerized registry of the healthcare system of the Lombardy Region (Italy). After calculating the annual T1D incidence, the incidence in 2020, prior to the availability of vaccination, was compared to subsequent years. A separate analysis was conducted for the 12–17 age group, the first to receive vaccination.

Results
One thousand two hundred seventy-three T1D onsets were recorded. The distribution of T1D showed no significant annual variation by sex (p-trend = 0.338), mean age (9 years, p = 0.537) and age distribution (p-trend = 0.563). T1D incidence [95% CI/100.000] did not significantly change comparing 2020 [18.94/100.000 (CI 16.88–21.18)] with 2021 [21.82/100.000 (CI 18.90–23.44)], 2022 [20.77/100.000 (CI 18.59–23.13)] and 2023 [19.68/100.000 (CI 16.61–20.94)]. No differences in incidence were observed in the 12–17 age group during 2021–2023 when COVID-19 vaccination was available when compared to 2020 (p-wald > 0.05). The COVID-19 vaccination coverage was lower in children with diabetes onset compared to the same-age general population (38 vs 42%).

Conclusions
The incidence of T1D in children remained stable during the COVID-19 pandemic, regardless of the uptake of the vaccination.
Cross-cultural adaptation and multicentric validation of the Italian version of the Simplified Evaluation of CONsciousness Disorders (SECONDs)
Authors: Hakiki Bahia , Pancani Silvia , De Nisco Agnese , Romoli Anna Maria , Draghi Francesca , Maccanti Daniela , Estraneo Anna , Magliacano Alfonso , Spinola Marcella , Fasano Cinzia , Leonardi Matilde , Cacciatore Martina , Magnani Francesca Giulia , Sattin Davide , Ippoliti Camilla , Barbadoro Filippo , Grippo Antonello , Macchi Claudio , Martial Charlotte , Gosseries Olivia , Cecchi Francesca 
Published: February 2025

Introduction
The Coma Recovery Scale-Revised (CRS-R) is the recommended tool to assess consciousness in patients with prolonged Disorders of Consciousness (pDoC). However, the time needed to administer it may limit its use. A shorter tool has been validated: the Simplified Evaluation of CONsciousness Disorders (SECONDs). This multicentre study aimed to develop and validate a cross-cultural adaptation of the SECONDs into Italian.

Methods
An interdisciplinary expert team, from both Fondazione Don Carlo Gnocchi and Istituto Neurologico Carlo Besta, led the translation processes. Independent certified translators were also involved in a blinded modality. Patients diagnosed with Unresponsive Wakefulness Syndrome (UWS) or Minimally Conscious State (MCS) admitted to 3 Italian rehabilitation units were enrolled. The CRS-R and SECONDs were administered in 5 sessions over two weeks by 3 blinded examiners at each center (3 times, with 2 sessions conducted by the same examiner). Weighted Fleiss’ kappa and Spearman correlation coefficients were used to assess intrarater and interrater reliability and concurrent validity.

Results
Sixty adults with pDoC were assessed: 23 women; median age: 64 years; 14 trauma, median post-onset time: 2 months. Intrarater and interrater reliability showed almost perfect agreement (kappa coefficients 0.968 and 0.935, respectively; p<0.001). The comparison of CRS-R vs. SECONDs on the same day or the best out of 5 SECONDs/CRS-R led to a substantial to almost perfect agreement both for the total score of the CRS-R and the SECONDs’ Additional Index (ρ = 0.772–1.000; p<0.001) and for the consciousness diagnosis (k = 0.784–0.935; p<0.001). The disagreement rate between the overall best diagnosis of the SECONDs and the best CRS-R diagnosis was 6.7%.

Conclusion
The Italian version of the SECONDs has been cross-culturally adapted to serve as a shorter assessment tool for the diagnosis of pDoC. Our study shows its excellent reliability and concurrent validity when compared to the CRS-R.
Breastfeeding self-efficacy status and associated factors among postpartum mothers at Hadiya Zone public hospitals, Southern Ethiopia
Authors: Nigussiee Lemlem , Demeke Tigist , Bagilkar Vinod , Firetsidk Yemisrach , Abageda Mulatu , Belachew Tefera 
Published: February 2025

Background
Breastfeeding is a crucial health-promoting behavior that has several positive effects on the health of both mothers and newborns. Breastfeeding self-efficacy (BFSE) status is an important factor that is positively related to breastfeeding, as it influences a woman’s decision to breastfeed or not. Therefore, the objective of this study is to assess the BFSE status and its associated factors among postpartum mothers at public hospitals in the Hadiya Zone.

Method
A cross-sectional study design was conducted from August 1–30, 2022, at public hospitals in the Hadiya Zone, southern Ethiopia. Data were collected from 416 participants using a pretested, structured questionnaire. Study participants were selected using a systematic random sampling technique from four public hospitals. The data were entered into Epi Data version 3.1 and analyzed using the SPSS version 24. Bivariable analysis was conducted initially, and variables with p values ≤ 0.25 were entered into multivariable logistic regression. Statistical significance was declared at a p value ≤ 0.05.

Results
The results of this study showed that 48% had a high level of BFSE. On multivariable logistic regression analysis, the variables age ≥ 35 years old [AOR = 3.596; 95% CI (1.564, 8.26)], age 20 to 34 [AOR = 2.352; 95% CI (1.2275, 4.506)], spontaneous vaginal delivery [AOR = 2.755; 95% CI (1.636, 5.566)], breastfeeding experience [AOR =1.845; 95% CI (1.028, 3.3)], more than secondary educational status [AOR = 6.856; 95% CI (2.670–17.603)], and intended pregnancy [AOR = 4.156; 95% CI (2.239, 7.714)] were significantly associated with high breastfeeding self-efficacy status.

Conclusion
The study findings suggest that mothers attending postpartum care at Hadiya Zone Hospital have a low status of breastfeeding self-efficacy. Therefore, efforts should be made to enhance mothers’ breastfeeding self-efficacy status before they are discharged from the hospital.
Validity of heart rate measurements in wrist-based monitors across skin tones during exercise
Authors: Hung Stanley Hughwa , Serwa Kelsey , Rosenthal Gillian , Eng Janice J. 
Published: February 2025

Purpose
To evaluate the accuracy of a wrist-based heart rate (HR) monitor at different exercise intensities across different skin tones.

Methods
Using a cross-sectional design, we compared HR measures from the wrist-based photoplethysmography Fitbit Charge 5 to the Polar H10 chest strap at rest and during the YMCA Protocol using a recumbent cycle ergometer. Participant were grouped into three skin tone categories: light (Fitzpatrick Scale Skin Types 1+2), medium (Types 3+4), and darker skin tone (Types 5+6). HR measures using the Polar chest strap during the exercise test were categorized as <40%, 40–60%, or >60% HR reserve (HRR). Absolute error in beats per minute (bpm) between the two devices was calculated for each measure. A linear mixed effects model was used to assess interaction effects between skin tone and exercise intensity, with participants as the random effect. Bland-Altman plots were used for visual analyses.

Results
Twenty-five participants [mean (SD): 25.8 (1.9) years old; 64% female] were included with 495 observations of simultaneous Fitbit and Polar HR recordings collected during exercise. During exercise, we observed a statistically significant interaction effect between skin tone and exercise intensity. Compared with light skin tone at <40% HRR, mean error was greater for medium skin tone at >60% HRR [mean error (95%CI): 11.8 (5.6–17.9) bpm, p<0.001] and darker skin tone at 40–60% HRR [7.6 (1.7–13.5) bpm, p = 0.011] and >60% HRR [11.7 (5.3–18.0) bpm, p<0.001].

Conclusion
HR measurement error using a wrist-based device was greater with increasing exercise intensity for people with darker skin tones.
Prevalence and associated factors of diabetic ketoacidosis among patients with diabetes mellitus at the University of Gondar Comprehensive and Specialized Referral Hospital Northwest, Ethiopia
Authors: Birhanu Abebe , Ambachew Sintayehu , Baye Netsanet , Getnet Emiyamrew , Admas Sintayehu , Gebrie Eshet , Worede Abebaw 
Published: February 2025

Background
Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Diabetic ketoacidosis is one of the life-threatening complications in diabetic individuals with, high morbidity and mortality globally. However, the data related to the prevalence and associated factors of diabetic ketoacidosis are limited in the study setting.

Objective
To assess the prevalence of diabetic ketoacidosis and its associated factors among diabetic mellitus patients at the University of Gondar Comprehensive Specialized Hospital.

Methods
A hospital-based cross-sectional study was conducted from March 1 to September 30, 2021. A total of 405 diabetic patients aged 20 and above were selected using a systematic random sampling technique. A total of 810 blood and urine samples (each 405) were collected using sterile serum separator tubes and urine collection cups, respectively. Sociodemographic and clinical data was collected using a structured questionnaire. Chemical analysis of urine was done using urine reagent strips to determine urine ketone bodies and PH. BECKMAN COULTER DxC700 AU clinical chemistry analyzer instrument was used to determine electrolytes and metabolites. The data was entered using Epi-Data version 4.6 and transferred to SPSS version 25 for analysis. Bivariable and multivariable logistic regression analyses were used to determine the factors associated with the diabetic ketoacidosis. The results were considered statistically significant if the adjusted odds ratio was reported with a 95% confidence interval and a P-value below 0.05.

Results
The overall prevalence of diabetic ketoacidosis among diabetic patients was 35/405 (8.6%, 95% CI: 6.0–11.0%). Of these cases, 25 (71.4%) had type 1 diabetes mellitus, while 10 (28.6%) had type 2 diabetes mellitus. Statistically significant factors associated with diabetic ketoacidosis included being a young adult aged 20–29 years (AOR = 2.262; 95% CI = 1.090–4.758; P = 0.013), unemployment (AOR = 2.578; 95% CI = 1.457–6.113; P = 0.017), the presence of infection (AOR = 2.819; 95% CI = 1.138–8.428; P = 0.024), and being T1DM (AOR = 3.106; 95% CI = 1.150–7.273; P = 0.003).

Conclusions and recommendations
The prevalence of diabetic ketoacidosis among follow-up diabetes patients in this study was high, particularly among those aged 20–29 years, unemployed, or with infections. Increased vigilance, regular monitoring, timely infection management, and comprehensive diabetes education are essential for early detection and prevention of DKA. Social and financial support for unemployed diabetic patients can further enhance access to care and reduce DKA risk.
First Patient Dosed in Phase 1 / 2a Trial Evaluating TUB-030 in Advanced Solid Tumors
Authors:   Sunvalley Communication, LLC / ADC Review, Hofland Peter 
Published: February 2025

A first patient was dosed in the clinical trial with TUB-030 (see: ADC Drug map), a 5T4-directed antibody-drug conjugate conjugated being developed by Tubulis built with ethynylphosphonamidate conjugation chemistry.
Rohingya Refugees in Southeast Asia: Problems and Proposed Solutions in Historical Analysis
Authors: Oktafia Sri Wahyuni , Pratama Adiva Wildan 
Published: February 2025

Abstract: This study discusses the humanitarian crisis involving the Rohingya, one of the most persecuted minority groups in the world. They are forced to flee and drift at sea in hopes of finding a better life. The aim of this research is to highlight the issues associated with the Rohingya refugee crisis and propose potential solutions. By using a qualitative approach and utilizing the concepts of crisis and refugees, this study examines the Rohingya refugee crisis. The findings of the study indicate that the Rohingya ethnic group has been experiencing a humanitarian crisis since the 1970s, forcing them to flee. The issues arising from this refugee crisis include the Rohingya Muslim group being stranded, rejected, experiencing death, starvation, suffering, and human trafficking. The solutions presented in this study, which also represent a novelty in the research, include: (1) The international community, particularly the UN, should evaluate its support and mediate between Myanmar and the refugees. (2) ASEAN countries must be more proactive in addressing the crisis. (3) Reform policies to ensure inclusivity and justice for all ethnic groups. (4) Criticize Myanmar’s policies toward the Rohingya through interfaith dialogue. Abstrak: Studi ini membahas krisis kemanusiaan yang dialami oleh Rohingya, salah satu kelompok minoritas yang paling teraniaya di dunia. Mereka terpaksa melarikan diri dan terombang-ambing di laut dengan harapan menemukan kehidupan yang lebih baik. Penelitian ini bertujuan untuk menyoroti permasalahan yang terkait dengan krisis pengungsi Rohingya dan mengusulkan solusi potensial. Dengan menggunakan pendekatan kualitatif serta konsep krisis dan pengungsi, studi ini menganalisis krisis pengungsi Rohingya. Temuan dalam penelitian ini menunjukkan bahwa kelompok etnis Rohingya telah mengalami krisis kemanusiaan sejak tahun 1970-an yang memaksa mereka untuk melarikan diri. Permasalahan yang muncul dari krisis ini mencakup kelompok Muslim Rohingya yang terdampar, ditolak, mengalami kematian, kelaparan, penderitaan, hingga perdagangan manusia. Solusi yang diajukan dalam studi ini menekankan pentingnya evaluasi dukungan komunitas internasional, terutama PBB, serta peran aktif negara-negara ASEAN dalam menangani krisis tersebut. Selain itu, diperlukan reformasi kebijakan untuk memastikan inklusivitas dan keadilan bagi semua kelompok etnis di Myanmar serta penguatan dialog lintas agama untuk mengkritisi kebijakan diskriminatif yang diterapkan terhadap Rohingya.