bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term outcome and predictors of long-term outcome in patients with lupus nephritis managed at a tertiary hospital in Mumbai
Authors: Yadav Sandeep , Balakrishnan C , Kothari Jatin 
Published: June 2022

Aim Study the long-term outcome of the patients with LN and identify the baseline factors that can predict the long-term outcome of these patients Methods All biopsy-proven LN patients who attended our regular ‘lupus nephritis’ clinic from 2013 to 2021 were studied. Data of these patients were collected from the hospital patient records. Standard therapy was given as per the KDIGO guidelines, and the renal response was evaluated according to KDIGO outcome criteria. Cox’ regression analysis was used to determine predictors of chronic kidney disease (persistent doubling of serum creatinine with creatinine ≥1.5 mg%). Kaplan–Meier analysis was used for renal survival. Results Eighty patients with at least 1 year of follow-up were included. Median age of onset was 24 years (IQR18-35). Median follow up was 6.5 years (IQR 3–10). World Health Organisation renal biopsy profile was Class I 1(1.2 %), Class II 6(7.5 %), Class III 9(11.2 %), Class IV 36(45 %), Class V 18(22.5 %) and Mixed Class IV + V 10 (12%). Complete remission was achieved in 63.75%, 70 % and 66.6% patients at 1, 2 and 5 years, respectively. Survival with normal renal function was 88.5 %, 85.8% and 60 % at 5, 10 and 15 years, respectively. Risk factors for poor outcome on univariate analysis were presence of Raynaud’s phenomena-hazard ratio(HR) 7.78 (CI 1.944–31.207; p < .004), baseline hypertension-HR 5.356 (CI 1.479–19.403; p < .011), tubulointerstitial involvement-HR 1.076 (CI 1.032–1.222; p < .001), time to complete response-HR 1.036 (CI 1.036–1.067; p < .02 ), serum creatinine at 6 months HR 10.51 (CI 2.19–50.39; p < .003), failure to achieve complete response at 2 years HR 6.271 (CI 1.567–25.092; p < .009) and the number of nephritic flares HR 1.868(CI 1.103–3.164 ; p < .02). Renal relapses were quite common, with 1.8 flares per 10 patient-years of follow up. Infection was the most common cause of death, with bacterial lower respiratory infections and pulmonary tuberculosis being the most common. Conclusions Apart from conventional risk factors, other predictive factors like the presence of Raynaud’s phenomenon, tubulointerstitial fibrosis and tubular atrophy on kidney biopsy, and initial response to induction therapy by 6 months have a significant impact on the long-term outcome in patients with LN.
Health Disparities Likely Emerge Early in the Course of Type-1 Diabetes in Youth
Authors: Tremblay Elise Schlissel , Liu Enju , Laffel Lori M. 
Published: June 2022

Background: Type-1 diabetes (T1D) management and glycemic control the year after diagnosis affects the long-term trajectory of T1D. Disparities in hemoglobin A1c (HbA1c) based on race, ethnicity, and socioeconomic status (SES) have been well-documented; however, there has been limited investigation into the timeline with which these disparities develop. This study aims to assess differences in HbA1c by race/ethnicity and SES among youth with T1D over 1 year post diagnosis. Methods: HbA1c at onset, and 3, 6, 9, and 12 months following diagnosis was collected from youth with T1D between 2016 and 2020. Mixed-effect models examined associations of HbA1c over time with race/ethnicity and SES. Results: Of 758 patients, 71% identified as white. Mean (± SD) HbA1c was 11.4% ± 2.2% at diagnosis and 7.3% ± 1.2%, 7.3% ± 1.3%, 7.7% ± 1.4%, and 7.9% ± 1.4% at 3, 6, 9, and 12 months, respectively. HbA1c trajectories over time differed significantly by race (adjusting for sex and zip-code education and poverty levels) with Hispanic and black youth demonstrating higher HbA1c 1 year after diagnosis (8.7% vs 7.7%, p < .001) than white youth. Conclusions: These data revealed that youth did not meet glycemic targets at 1 year post diagnosis and that racial/ethnic minority youth had higher HbA1c 1 year post diagnosis, highlighting the need to optimize glycemic control and mitigate disparities early. Understanding the time course of these outcomes helps to inform the need for early interventions, particularly in disadvantaged patient populations, to lay the groundwork for improved control. Further research must also be done to better understand overlapping axes of disparities including race, ethnicity, and SES.
Multidrug-resistant bacteria with ESBL genes: a growing threat among people living with HIV/AIDS in Nepal
Authors: Maharjan Riju , Bastola Anup , Adhikari Nabaraj , Rijal Komal Raj , Banjara Megha Raj , Ghimire Prakash , Shrestha Upendra Thapa 
Published: June 2022

Abstract
Background
Bacterial opportunistic infections are common in people living with HIV/AIDS (PLHA). Besides HIV-TB co-infection, lower respiratory tract infections (LRTIs) due to multidrug-resistant (MDR) bacteria cause significant morbidity and mortality among PLHA. This study identified bacterial co-infection of the lower respiratory tract and detected plasmid-mediated blaTEM and blaCTX-M genes among Extended-Spectrum β-Lactamase (ESBL) producing isolates from sputum samples in PLHA.

Methods
A total of 263 PLHA with LRTIs were enrolled in this study, out of which, 50 were smokers, 70 had previous pulmonary tuberculosis, and 21 had CD4 count < 200 cells/µl. Sputum samples collected from PLHA were processed with standard microbiological methods to identify the possible bacterial pathogens. The identified bacterial isolates were assessed for antibiotic susceptibility pattern using modified Kirby Bauer disk diffusion method following Clinical Laboratory Standard Institute (CLSI) guidelines. In addition, plasmid DNA was extracted from MDR and ESBL producers for screening of ESBL genes; blaCTX-M and blaTEM by conventional PCR method using specific primers.

Results
Of 263 sputum samples, 67 (25.48%) showed bacterial growth. Among different bacterial pathogens, Klebsiella pneumoniae, (17; 25.37%) was the most predominant, followed by Haemophillus influenzae, (14; 20.90%) and Escherichia coli, (12; 17.91%). A higher infection rate (4/8; 50%) was observed among people aged 61–70 years, whereas no infection was observed below 20 years. About 30.0% (15/50) of smokers, 32.86% (23/70) cases with previous pulmonary tuberculosis, and 52.38% (11/21) with CD4 count < 200 cells/µl had bacterial LRTIs. Among 53 bacterial isolates excluding H. influenzae, 28 isolates were MDR and 23 were ESBL producers. All ESBL producers were sensitive to colistin and polymyxin B. Among ESBL producers, 47.83% (11/23) possessed blaCTX-M, 8.6% (2/23) were positive for blaTEM gene, and 43.48% (10/23) possessed both ESBL genes.

Conclusion
The increasing rate of MDR bacterial infections, mainly ESBL producers of LRTIs causes difficulty in disease management, leading to high morbidity and mortality of PLHA. Hence, it is crucial to know the antibiogram pattern of the isolates to recommend effective antimicrobial therapy to treat LRTIs in PLHA.
Real-world disease-modifying therapy pathways from administrative claims data in patients with multiple sclerosis
Authors: Fox Robert J. , Mehta Rina , Pham Timothy , Park Julie , Wilson Kathleen , Bonafede Machaon 
Published: June 2022

Abstract
Background
Over a dozen disease-modifying therapies (DMTs) have been approved for treatment of multiple sclerosis (MS). Treatment guidelines focus on when to initiate, change, and discontinue treatment but provide little guidance on how to select or sequence DMTs. This study assessed sequencing patterns of DMTs in patients with newly diagnosed MS.

Methods
Adults newly diagnosed with MS in the United States were identified from January 2007 to October 2017 using IBM MarketScan database. Patients had ≥12 months of continuous enrollment prior to diagnosis and ≥ 2 years of follow-up. Treatment pathways consisting of up to 3 DMT courses were reported, and each treatment course ended with discontinuation, switch, or end of follow-up.

Results
In total, 14,627 MS patients were treated with DMTs and had ≥2 years of follow-up. More than 400 DMT treatment pathways were observed. Glatiramer acetate was the most common DMT; 40% of patients initiated this treatment. Among these, 51.3% had 2 DMT courses during follow-up and 26.5% had 3 DMT courses. Approximately 70% of patients switched or discontinued their initial DMT, and rates of switch and discontinuation differed by initial DMT. Injectable DMTs were used most commonly over the study period (87.5% as first course to 66.6% as third course). Oral DMTs were more common as second or third treatment courses (29.9% and 31.8%, respectively).

Conclusions
A wide variety in treatment patterns were observed among patients newly diagnosed with MS. Further examination of DMT prescribing practices is needed to understand the reasons behind treatment discontinuation and treatment cycling.
Influence of parental weight change on the incidence of overweight and obesity in offspring
Authors: Fan Hui , Zhang Xingyu 
Published: June 2022

Abstract
Background
There is limited information on the association of parental weight change with overweight and obesity in offspring. This study aimed to investigate the association between parental weight change and incident overweight and obesity in offspring.

Methods
This longitudinal cohort study included 2,963 parent–offspring trios who participated in at least two waves of the China Health and Nutrition Survey. The children without overweight and obesity defined by the International Obesity Task Force were included at the initial survey. Parental overweight and obesity were defined as body mass index ≥ 25 kg/m2.

Results
The incidence of overweight and obesity in offspring was 5.8% during a mean follow-up of 5.4 years. Paternal and maternal overweight and obesity at baseline were associated with this condition in offspring at follow-up (both Ps < 0.05). Compared with the persistent normal group, the persistent overweight and obesity group and incident overweight and obesity group (normal weight to overweight and obesity), but not the reversion group (overweight and obesity to normal weight), were more likely to report overweight and obesity in offspring at follow-up, regardless of father’s or mother’s condition. Additionally, compared with offspring whose both parents remained normal weight, those whose both parents changed from overweight and obesity to normal weight or whose one parent changed from overweight and obesity to normal weight while the other remained normal weight had no higher risks of overweight and obesity.

Conclusion
This study highlights the importance of parental weight management in the prevention of overweight/obesity in offspring.
Risk factors of sleep paralysis in a population of Polish students
Authors: Wróbel-Knybel Paulina , Flis Michał , Rog Joanna , Jalal Baland , Karakuła-Juchnowicz Hanna 
Published: June 2022

Abstract
Background
Sleep paralysis (SP) is a transitional dissociative state associated with the REM sleep phase that affects approximately 28.3% of the student population during their lifetime. The reasons for the high prevalence of SP in the student population are not entirely clear. Research indicates possible influencing factors such as the intensification of anxiety symptoms, a tendency to worry, the presence of PTSD symptoms, and behavioral factors such as the consumption of psychoactive substances (caffeine, alcohol, nicotine), sleep deprivations and poor sleep hygiene. The study aimed to assess the prevalence of SP and determine the risk factors for the occurrence of SP in the population of Polish students.

Methods
The study used a battery online consisting of a set of questionnaires 1) a personal questionnaire, 2) the SP-EPQ, 3) the PCL −5, 4) the STAI-T, 5) the PSWQ. The questionnaire was sent via Facebook to 4500 randomly selected students from different universities in Poland. The questionnaire was completed by 2598 students. To unify the participant sample, people over 35 were excluded from the study (45 students). Ultimately, data from 2553 students were analyzed.

Results
A total of 33.14% of individuals experienced at least one episode of SP in their lives. The highest odds ratio for SP was associated with: the presence of three or more health problems (OR: 2.3; p = 0.002), the presence of any mental disorder (OR: 1.77; p = 0.002), including mood disorders (OR: 2.07; p = 0.002), suffering from at least one somatic disease (OR: 1.34; p = 0.002), a high level of anxiety as a constant personality trait (OR: 1.20; p = 0.035) and smoking (OR: 1.48; p = 0.0002), alcohol consumption (OR: 1.52; p < 0.0001), physical activity (OR: 1.31; p = 0.001).

Conclusions
The results of our research indicate that a large proportion of students experienced isolated sleep paralysis. Mental and somatic health problems and lifestyle factors were found to predispose individuals to this disorder. Due to the numerous risk factors for SP, it is necessary to conduct additional research to confirm the impact of these factors and to investigate the mechanisms of their influence on SP.
Understanding determinants of COVID-19 vaccine hesitancy; an emphasis on the role of religious affiliation and individual’s reliance on traditional remedy
Authors: Hassen Hanna Defar , Welde Mengistu , Menebo Mesay Moges 
Published: June 2022

Abstract
Background
The damage COVID-19 has caused interms of mortalities, economic breakdown and social disruption is immense. The COVID-19 vaccine has been one of the efficient prevention strategies so far in preventing the pandemic. However, the publics’ hesitancy towards vaccines has enormously affected this task. With emerging research findings indicating that a substantial proportion of adults are hesitant about a vaccine for COVID-19, important work that identifies and describes vaccine hesitant individuals is required to begin to understand and address this problem.

Objective
This study assessed public attitude towards COVID-19 Vaccine and identified important factors that lead to its hesitancy.

Methods
A web and paper-based cross-sectional survey study was conducted from July 31 to August 12, 2021. The study participants are staffs and students at Jimma University. A total of 358 participants were selected using stratified simple random sampling and requested to fill a survey questionnaire. Binomial logistic regression analysis was done to identify factors associated with COVID-19 vaccine hesitancy.

Results
Half of the participants were found to be hesitant to COVID-19 vaccine. The odds of becoming vaccine hesitant among middle income was two times more than those with lower income (AOR 2.17, 95% CI 1.05–4.5). Furthermore, respondent’s extent of exposure was associated with vaccine hesitancy with the odds of becoming vaccine hesitant among those whose source of COVID-19 information is from four media sources (Social Media, Mass Media, Health care worker and Friends/family/Neighbor) being 74% lower (AOR .26, 95% CI .09–.69) than those with one media source. Concern towards vaccine side effect, vaccine effectiveness and having the belief to treat COVID-19 with traditional remedies were found to increase the odds of becoming vaccine hesitant by 31%, 42% and 37% respectively. Moreover, the association between side-effect concern and vaccine hesitancy was moderated by participant’s religious affiliation.
The diurnal pattern and social context of screen behaviours in adolescents: a cross-sectional analysis of the Millennium Cohort Study
Authors: Kontostoli Elli , Jones Andy P. , Atkin Andrew J. 
Published: June 2022

Abstract
Background
Screen behaviours are highly prevalent in young people and excessive screen use may pose a risk to physical and mental health. Understanding the timing and social settings in which young people accumulate screen time may help to inform the design of interventions to limit screen use. This study aimed to describe diurnal patterns in adolescents’ screen-based behaviours and examine the association of social context with these behaviours on weekdays and weekend days.

Methods
Time use diary data are from the sixth wave (2015/2016) of the Millennium Cohort Study, conducted when participants were aged 14 years. Outcome variables were electronic games/Apps, TV-viewing, phone calls and emails/texts, visiting social networking sites and internet browsing. Social context was categorised as alone only, parents only, friends only, siblings only, parents and siblings only. Multilevel multivariable logistic regression was used to examine the association between social contexts and screen activities.

Results
Time spent in TV-viewing was greatest in the evening with a peak of 20 min in every hour between 20:00 and 22:00 in both sexes on weekdays/weekend days. Time spent using electronic games/Apps for boys and social network sites for girls was greatest in the afternoon/evening on weekdays and early afternoon/late evening on weekend days. Screen activities were mainly undertaken alone, except for TV-viewing. Compared to being alone, being with family members was associated with (Odds Ratio (95% Confidence Interval)) more time in TV-viewing in both boys and girls throughout the week (Weekdays: Boys, 2.84 (2.59, 3.11); Girls, 2.25 (2.09, 2.43); Weekend days: Boys, 4.40 (4.16, 4.67); Girls, 5.02 (4.77, 5.27)). Being with friends was associated with more time using electronic games on weekend days in both sexes (Boys, 3.31 (3.12, 3.51); Girls, 3.13 (2.67, 3.67)).

Conclusions
Reductions in screen behaviours may be targeted throughout the day but should be sensitive to differing context. Family members, friends, and adolescent themselves may be important target groups in behaviour change interventions. Future research to address the complex interplay between social context, content and quality of screen behaviours will aid the design of behaviour change interventions.
The influence of two photobiomodulation protocols on orthodontically induced inflammatory root resorption (a randomized controlled clinical trial)
Authors: Eid Farah Y. , El-Kenany Walid A. , Mowafy Mohamed I. , El-Kalza Ahmed R. 
Published: June 2022

Abstract
Background
Controversial results have been reported regarding the impact of photobiomodulation (PBM) on orthodontically induced inflammatory root resorption (OIIRR). The aim of this study was to evaluate the influence of two PBM protocols, one of them requiring a high application frequency (on days 0, 3, 7, 14, then every 2 weeks), while the second requires less frequent applications (every 3 weeks), on OIIRR accompanying orthodontic treatment.

Methods
Twenty female patients were recruited for this randomized controlled trial, requiring the therapeutic extraction of maxillary first premolars, and they were randomly divided into 2 equal groups. In Group A, one side of the maxillary arch randomly received PBM on days 0, 3, 7, 14, and every 2 weeks thereafter, while in Group B, one side was randomly chosen to receive PBM every 3 weeks. The laser applied was a Diode laser with a wavelength of 980 nm, in a continuous mode. Canine retraction in both groups was carried out using closed-coil springs, delivering 150 g of force, and the force level was checked every 3 weeks, over a 12-week study period. Pre-retraction and post-retraction cone-beam computed tomography (CBCT) was done for the evaluation of OIIRR.

Results
No significant differences in the amount of OIIRR have been reported between the laser and control sides in both groups A and B. Also, no significant differences have been reported between the laser sides in both groups.

Conclusions
Photobiomodulation does not affect OIIRR, whether by increasing or decreasing its occurrence, with both laser application protocols. Therefore, it can be stated that PBM does not result in root resorption less than the commonly observed range elicited with conventional orthodontic treatment, and that it has no effect on OIIRR.
Trial registration Two Low-level Laser Irradiation Protocols on the Rate of Canine Retraction (NCT04926389), 15/06/2021—retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT04926389.
Student physiotherapists perceptions of online curriculum delivery during the COVID-19 pandemic
Authors: Chesterton Paul , Richardson Mark , Tears Craig 
Published: June 2022

Abstract
Background
As a result of the COVID-19 pandemic a rapid transformation from face-to-face curriculum delivery to an online teaching and learning environment, was adopted in a number of higher education institutions globally. Allied Health Profession courses such as physiotherapy, traditionally utilising an in person teaching model to prepare students for practice, needed to swiftly adopt new methods of delivery, involving both synchronous and asynchronous approaches. Understanding physiotherapy student perceptions of this transition is important to allow faculty to develop their delivery of online teaching and provide an evidence base for future course curricula.

Methods
Cross-sectional survey of UK higher education students studying either an undergraduate or post-graduate pre-registration degree in physiotherapy was conducted between October 2020 and February 2021. The survey investigated the student’s perception of the transition to either an online or hybrid model of learning during the COVID-19 pandemic. A mixed method approach was adopted allowing respondents to share their experiences and facilitate the exploration of questions which required in-depth thought.

Results
Two hundred thirty-six respondents completed the questionnaire. Online learning was perceived to be a flexible (49%, n=116,CI 95% 43 to 55) and convenient (49, 116, 43 to 55) method of learning. Despite this, 79% of the students surveyed felt that the online learning experience had a negative impact on their understanding of the subject and were disadvantaged compared to traditional face-to-face teaching provision (mean 4.14 ± SD 1.06). Online physiotherapy delivery produced low student satisfaction, leaving respondents feeling disadvantaged. Decreased levels of engagement and the lack of ability to practice ‘hands-on’ skills were detrimental aspects of the online approach, with 55% (n=106) reporting they did not perceive the academic staff had the necessary skills to deliver effective online content.

Conclusions
The majority of UK physiotherapy students surveyed were dissatisfied and lacked engagement with an online learning approach within the curricula, compared with the traditional face-to-face delivery. Although several positives of both a synchronous and asynchronous delivery were highlighted, faculty must consider how they best deliver online learning content, making use of pedagogical strategies that will create as many learning and engagement opportunities as possible.