bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case-control study of adverse childhood experiences and multiple sclerosis risk and clinical outcomes
Authors: Horton Mary K. , McCurdy Shannon , Shao Xiaorong , Bellesis Kalliope , Chinn Terrence , Schaefer Catherine , Barcellos Lisa F. 
Published: January 2022

BackgroundAdverse childhood experiences (ACEs) are linked to numerous health conditions but understudied in multiple sclerosis (MS). This study’s objective was to test for the association between ACEs and MS risk and several clinical outcomes.MethodsWe used a sample of adult, non-Hispanic MS cases (n = 1422) and controls (n = 1185) from Northern California. Eighteen ACEs were assessed including parent divorce, parent death, and abuse. Outcomes included MS risk, age of MS onset, Multiple Sclerosis Severity Scale score, and use of a walking aid. Logistic and linear regression estimated odds ratios (ORs) (and beta coefficients) and 95% confidence intervals (CIs) for ACEs operationalized as any/none, counts, individual events, and latent factors/patterns.ResultsOverall, more MS cases experienced ≥1 ACE compared to controls (54.5% and 53.8%, respectively). After adjusting for sex, birthyear, and race, this small difference was attenuated (OR = 1.01, 95% CI: 0.87, 1.18). There were no trends of increasing or decreasing odds of MS across ACE count categories. Consistent associations between individual ACEs between ages 0–10 and 11–20 years and MS risk were not detected. Factor analysis identified five latent ACE factors, but their associations with MS risk were approximately null. Age of MS onset and other clinical outcomes were not associated with ACEs after multiple testing correction.ConclusionDespite rich data and multiple approaches to operationalizing ACEs, no consistent and statistically significant effects were observed between ACEs with MS. This highlights the challenges of studying sensitive, retrospective events among adults that occurred decades before data collection.
Emergency department utilization for substance use disorders and mental health conditions during COVID-19
Authors: Venkatesh Arjun K. , Janke Alexander T. , Kinsman Jeremy , Rothenberg Craig , Goyal Pawan , Malicki Caitlin , D’Onofrio Gail , Taylor Andrew , Hawk Kathryn 
Published: January 2022

Background
As the emergency department (ED) has evolved into the de-facto site of care for a variety of substance use disorder (SUD) presentations, trends in ED utilization are an essential public health surveillance tool. Changes in ED visit patterns during the COVID-19 pandemic may reflect changes in access to outpatient treatment, changes in SUD incidence, or the unintended effects of public policy to mitigate COVID-19. We use a national emergency medicine registry to describe and characterize trends in ED visitation for SUDs since 2019.

Methods
We included all ED visits identified in a national emergency medicine clinical quality registry, which included 174 sites across 33 states with data from January 2019 through June 2021. We defined SUD using ED visit diagnosis codes including: opioid overdose and opioid use disorder (OUD), alcohol use disorders (AUD), and other SUD. To characterize changes in ED utilization, we plotted the 3-week moving average ratio of visit counts in 2020 and 2021 as compared to visit counts in 2019.

Findings
While overall ED visits declined in the early pandemic period and had not returned to 2019 baseline by June 2021, ED visit counts for SUD demonstrated smaller declines in March and April of 2020, so that the proportion of overall ED visits that were for SUD increased. Furthermore, in the second half of 2020, ED visits for SUD returned to baseline, and increased above baseline for OUD ever since May 2020.

Conclusions
We observe distinct patterns in ED visitation for SUDs over the course of the COVID-19 pandemic, particularly for OUD for which ED visitation barely declined and now exceeds previous baselines. These trends likely demonstrate the essential role of hospital-based EDs in providing 24/7/365 care for people with SUDs and mental health conditions. Allocation of resources must be directed towards the ED as a de-facto safety net for populations in crisis.
Baseline procalcitonin as a predictor of bacterial infection and clinical outcomes in COVID-19: A case-control study
Authors: Atallah Natalie J. , Warren Hailey M. , Roberts Matthew B. , Elshaboury Ramy H. , Bidell Monique R. , Gandhi Ronak G. , Adamsick Meagan , Ibrahim Maryam K. , Sood Rupali , Bou Zein Eddine Savo , Cobler-Lichter Matthew J. , Alexander Natalie J. , Timmer Kyle D. , Atallah Christine J. , Viens Adam L. , Panossian Vahe S. , Scherer Allison K. , Proctor Teddie , Smartt Sherrie , Letourneau Alyssa R. , Paras Molly L. , Johannes Sascha , Wiemer Jan , Mansour Michael K. 
Published: January 2022

Purpose
Coronavirus disease-2019 (COVID-19) is associated with a wide spectrum of clinical symptoms including acute respiratory failure. Biomarkers that can predict outcomes in patients with COVID-19 can assist with patient management. The aim of this study is to evaluate whether procalcitonin (PCT) can predict clinical outcome and bacterial superinfection in patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).

Methods
Adult patients diagnosed with SARS-CoV-2 by nasopharyngeal PCR who were admitted to a tertiary care center in Boston, MA with SARS-CoV-2 infection between March 17 and April 30, 2020 with a baseline PCT value were studied. Patients who were presumed positive for SARS-CoV-2, who lacked PCT levels, or who had a positive urinalysis with negative cultures were excluded. Demographics, clinical and laboratory data were extracted from the electronic medical records.

Results
324 patient charts were reviewed and grouped by clinical and microbiologic outcomes by day 28. Baseline PCT levels were significantly higher for patients who were treated for true bacteremia (p = 0.0005) and bacterial pneumonia (p = 0.00077) compared with the non-bacterial infection group. Baseline PCT positively correlated with the NIAID ordinal scale and survival over time. When compared to other inflammatory biomarkers, PCT showed superiority in predicting bacteremia.

Conclusions
Baseline PCT levels are associated with outcome and bacterial superinfection in patients hospitalized with SARS-CoV-2.
Loneliness among people with severe mental illness during the COVID-19 pandemic: Results from a linked UK population cohort study
Authors: Heron Paul , Spanakis Panagiotis , Crosland Suzanne , Johnston Gordon , Newbronner Elizabeth , Wadman Ruth , Walker Lauren , Gilbody Simon , Peckham Emily 
Published: January 2022

Aim/Goal/Purpose
Population surveys underrepresent people with severe mental ill health. This paper aims to use multiple regression analyses to explore perceived social support, loneliness and factor associations from self-report survey data collected during the Covid-19 pandemic in a sample of individuals with severe mental ill health.

Design/Methodology/Approach
We sampled an already existing cohort of people with severe mental ill health. Researchers contacted participants by phone or by post to invite them to take part in a survey about how the pandemic restrictions had impacted health, Covid-19 experiences, perceived social support, employment and loneliness. Loneliness was measured by the three item UCLA loneliness scale.

Findings
In the pandemic sub-cohort, 367 adults with a severe mental ill health diagnosis completed a remote survey. 29–34% of participants reported being lonely. Loneliness was associated with being younger in age (adjusted OR = -.98, p = .02), living alone (adjusted OR = 2.04, p = .01), high levels of social and economic deprivation (adjusted OR = 2.49, p = .04), and lower perceived social support (B = -5.86, p < .001). Living alone was associated with lower perceived social support. Being lonely was associated with a self-reported deterioration in mental health during the pandemic (adjusted OR = 3.46, 95%CI 2.03–5.91).

Practical implications
Intervention strategies to tackle loneliness in the severe mental ill health population are needed. Further research is needed to follow-up the severe mental ill health population after pandemic restrictions are lifted to understand perceived social support and loneliness trends.

Originality
Loneliness was a substantial problem for the severe mental ill health population before the Covid-19 pandemic but there is limited evidence to understand perceived social support and loneliness trends during the pandemic.
Immune correlates of Mycobacterium Tuberculosis patients in Zambia stratified by HIV serostatus and level of immunity-a cross-sectional analytical laboratory based study
Authors: Lungu Patrick , Njelesani Evarist , Sukwa Thomas , Ngalamika Owen , Munsaka Sody , Kilembe William , Lakhi Shabir , Mwaba Peter 
Published: January 2022

BackgroundPeople living with HIV (PLHIV) co-infected with tuberculosis (TB) have a distinct clinical presentation and poorer treatment outcomes compared to HIV-seronegative TB patients. Excluding low CD4 count, innate immune factors associated with TB are not fully elucidated. We, therefore, characterised and compared the expression of IL-6, TNF-α, IFN-γ, and IL-10 in whole blood of treatment naïve TB patients stimulated with heat-killed Mycobacterium tuberculosis stratified by HIV status and the level of CD4 count.ResultsWe recruited 39 HIV seropositive and 31 HIV seronegative TB patients. Median (IQR) age was 35(28–42) years and 31(25–36) years respectively, and a majority had pulmonary tuberculosis i.e. 38(95%) and 30(97%), respectively. The two groups were significantly different in the distribution of CD4 count, 563 [465–702.5 cells/mm3] vs 345 [157–483 cell/mm3] in HIV negative vs HIV positive respectivelyp= <0.001. Post stimulation, the expression of IL-6 in HIV negative TB patients was significantly higher than in the HIV positive 16,757366 [8,827–23,686 pg/ml] vs. 9,508 [5,514–15,008 pg/ml], respectively;p= 0.0360. TNF-α and IFN-γ were highly expressed in HIV negative TB patients compared to the HIV positive though not statistically significant. We only observed higher expression of IL-6 in HIV negative patients in comparison to the HIV positive when stratified by level of CD4 counts as < 500 and ≥ 500 cell/mm3for both cohorts. 21,953 [8,990–24,206 pg/ml] vs 9,505 [5,400–15,313 pg/ml],pvalue = 0.0585 in patients with CD4 count < 500 cell/mm3and 13,168 [7,087–22,584 pg/ml] vs 10,413 [7,397–14,806 pg/ml],pvalue = 0.3744 for patients with CD4 count of ≥ 500 cell/mm3 respectively. We found a positive pairwise correlation between TNF-α -alpha and IL-6 in both HIV positive and HIV negative patients, r = 0.61 (95% CI 0.36–0.72;p< 0.0001) and r = 0.48 (95% CI 0.15–0.68;p= 0.005) respectively. The IFNγ/IL-10 ratio was higher in HIV negative when compared to HIV positive individuals, 0.052 [0.0–0.28] vs 0.007 [0–0.32] respectively;p= 0.05759. IL-6 independently reduced the probability of TB/HIV, Adjusted odds ratio 0.99,pvalue 0.007.ConclusionsThis study suggests that HIV seronegative TB patients have a higher pro-inflammatory response to MTB than HIV seropositive TB patients. Further, it also shows that the level of CD4 influences immunomodulation. The findings suggest that the difference in cytokine expression may be responsible for the distinct patterns of TB presentation between HIV positive and HIV negative patient.
Ramadan is not associated with increased infection risk in Pakistani and Bangladeshi populations: Findings from controlled interrupted time series analysis of UK primary care data
Authors: Almulhem Munerah , Thayakaran Rasiah , Hanif Shahjehan , Gooden Tiffany , Thomas Neil , Hazlehurst Jonathan , Tahrani Abd A. , Hanif Wasim , Nirantharakumar Krishnarajah 
Published: January 2022

BackgroundThe effect of fasting on immunity is unclear. Prolonged fasting is thought to increase the risk of infection due to dehydration. This study describes antibiotic prescribing patterns before, during, and after Ramadan in a primary care setting within the Pakistani and Bangladeshi populations in the UK, most of whom are Muslims, compared to those who do not observe Ramadan.MethodRetrospective controlled interrupted time series analysis of electronic health record data from primary care practices. The study consists of two groups: Pakistanis/Bangladeshis and white populations. For each group, we constructed a series of aggregated, daily prescription data from 2007 to 2017 for the 30 days preceding, during, and after Ramadan, respectively.FindingsControlling for the rate in the white population, there was no evidence of increased antibiotic prescription in the Pakistani/Bangladeshi population during Ramadan, as compared to before Ramadan (IRR: 0.994; 95% CI: 0.988–1.001, p = 0.082) or after Ramadan (IRR: 1.006; 95% CI: 0.999–1.013, p = 0.082).InterpretationIn this large, population-based study, we did not find any evidence to suggest that fasting was associated with an increased susceptibility to infection.
Patient-reported outcomes among people living with HIV on single- versus multi-tablet regimens: Data from a real-life setting
Authors: Degroote Sophie , Vandekerckhove Linos , Vogelaers Dirk , Vanden Bulcke Charlotte 
Published: January 2022

BackgroundThe use of single-tablet regimens (STRs) in HIV treatment is ubiquitous. However, reintroducing the (generic) components as multi-tablet regimens (MTRs) could be an interesting cost-reducing strategy. It is essential to involve patient-reported outcome measures (PROs) to examine the effects of such an approach. Hence, this study compared PROs of people living with HIV taking an STR versus a MTR in a real world setting.Materials and methodsThis longitudinal study included 188 people living with HIV. 132 remained on a MTR and 56 switched to an STR. At baseline, months 1-3-6-12-18 and 24, participants filled in questionnaires on health-related quality of life (HRQoL), depressive symptoms, HIV symptoms, neurocognitive complaints (NCC), treatment satisfaction and adherence. Generalized linear mixed models and generalized estimation equations mixed models were built.ResultsClinical parameters and PROs of the two groups were comparable at baseline. Neurocognitive complaints and treatment satisfaction did differ over time among the groups. In the STR-group, the odds of having NCC increased monthly by 4,1% as compared to the MTR-group (p = 0.035). Moreover, people taking an STR were more satisfied with their treatment after 6 months: the median change score was high: 24 (IQR 7,5–29). Further, treatment satisfaction showed a contrary evolution in the groups: the estimated state score of the STR-group increased by 3,3 while it decreased by 0,2 in the MTR-group (p = 0.003). No differences over time between the groups were observed with regard to HRQoL, HIV symptoms, depressive symptoms and adherence.ConclusionsNeurocognitive complaints were more frequently reported among people on an STR versus MTR. This finding contrasts with the higher treatment satisfaction in the STR-group over time. The long-term effects of both PROs should guide the decision-making on STRs vs. (generic) MTRs.
A structured additive modeling of diabetes and hypertension in Northeast India
Authors: Marbaniang Strong P. , Chungkham Holendro Singh , Lhungdim Hemkhothang 
Published: January 2022

BackgroundMultiple factors are associated with the risk of diabetes and hypertension. In India, they vary widely even from one district to another. Therefore, strategies for controlling diabetes and hypertension should appropriately address local risk factors and take into account the specific causes of the prevalence of diabetes and hypertension at sub-population levels and in specific settings. This paper examines the demographic and socioeconomic risk factors as well as the spatial disparity of diabetes and hypertension among adults aged 15–49 years in Northeast India.MethodsThe study used data from the Indian Demographic Health Survey, which was conducted across the country between 2015 and 2016. All men and women between the ages of 15 and 49 years were tested for diabetes and hypertension as part of the survey. A Bayesian geo-additive model was used to determine the risk factors of diabetes and hypertension.ResultsThe prevalence rates of diabetes and hypertension in Northeast India were, respectively, 6.38% and 16.21%. The prevalence was higher among males, urban residents, and those who were widowed/divorced/separated. The functional relationship between household wealth index and diabetes and hypertension was found to be an inverted U-shape. As the household wealth status increased, its effect on diabetes also increased. However, interestingly, the inverse was observed in the case of hypertension, that is, as the household wealth status increased, its effect on hypertension decreased. The unstructured spatial variation in diabetes was mainly due to the unobserved risk factors present within a district that were not related to the nearby districts, while for hypertension, the structured spatial variation was due to the unobserved factors that were related to the nearby districts.ConclusionDiabetes and hypertension control measures should consider both local and non-local factors that contribute to the spatial heterogeneity. More importance should be given to efforts aimed at evaluating district-specific factors in the prevalence of diabetes within a region.
Analog and digital modeling of sound and impaired periodontal
supporting tissues during mechanical testing
Authors: Szabó Veronika T. , Szabó Balázs , Tarjányi Tamás , Szőke-Trenyik Eszter , Szabó Balázs P. , Fráter Márk 
Published: January 2022

Periodontitis is one of the most common conditions affecting oral
health among adults, posing a great challenge for both patients and also
for dentists aiming to treat this disease. In severe stages such
deterioration of the supporting tissues, namely the periodontal ligaments
and the bone, can occur, which will affect the biomechanical behavior and
therefore the longevity and survival of the affected teeth. In order to be
able to plan both periodontal and subsequent restorative treatment
properly, valid modelling of the current clinical situation is advised. The
aim of the present article is to comprehensively discuss possible analog
and digital modeling methods of periodontally affected teeth and the
periodontal structures surrounding them. Modelling possibilities can serve
later as the basis of mechanical load, digital finite element studies, and
also aid clinical treatment planning.
Menginvestigasi Kunci Penentu Keberhasilan Usaha Pada Profesi Notaris (Studi Fenomenologi Terhadap Notaris di Kota Semarang dan Sekitarnya)
Authors: Antawati Rika Budi , Mas'ud Fuad 
Published: January 2022

ABSTRAK Dalam satu dasa warsa terakhir, jumlah notaris meningkat secara signifikan dikarenakan melonjaknya jumlah perguruan tinggi yang menyelenggarakan pendidikan notaris. Kondisi ini mengakibatkan meningkatnya persaingan antar notaris. Agar dapat terus bertahan dan menambah klien, seorang notaris dituntut untuk melakukan inovasi yang mendukung pelayanan prima dalam mengelola bisnisnya. Sayangnya mayoritas notaris tidak memiliki bekal pengetahuan manajemen. Literatur yang membahas kiet sukses dalam berkarir sebagai notaris juga sangat jarang ditemui. Hal tersebut menjadi dasar dari penelitian ini untuk menginvestigasi faktor-faktor yang menyebabkan seorang notaris mampu untuk bertahan, berkembang dan mengembangkan relasinya.Penelitian ini menggunakan metode fenomenologi terhadap notaris yang telah menjalankan jabatannya selama 15 tahun dan membuat akta notariil minimal 100 dalam setiap tahunnya. Kriteria tersebut dijadikan dasar untuk mengivestigasi masing-masing notaris hingga dapat berkembang seperti saat ini. Terdapat 5 kantor notaris yang diivestigasi dalam penelitian ini. Kantor-kantor tersebut berlokasi di Kota Semarang dan Kabupaten Semarang. Sebanyak 15 pertanyaan yang berkaitan dengan faktor penentu keberhasilan bisnis digunakan dalam wawancara dengan masing-masing notaris.Dari hasil penelitian ditemukan beberapa faktor yang dapat menjadi penentu keberhasilan notaris dalam menjalankan jabatannya. Dari berbagai faktor tersebut, proses manajemen sumber daya manusia yang baik menjadi penentu untuk keberhasilan. Kantor notaris disarankan melakukan refleksi gaya kepemimpinan serta pembenahan rekrutmen, seleksi, pendidikan dan pelatihan serta kompetensi bagi karyawan. Beberapa implikasi manajerial dalma pengelolaan kantor notaris juga akan didiskusikan dalam penelitian ini. Kata kunci : Key Success Factors, Notaris, Profesional, Kualitatif, Fenomenologi
Pengaruh Customer Relationship Management (CRM), Inovasi, dan Penggunaan Teknologi Sebagai Strategi Keunggulan Bersaing untuk Meningkatkan Kinerja Bisnis (Studi pada Toko Grosir Makanan dan Minuman di Provinsi Jawa Tengah dan DI Yogyakarta)
Authors: Setiawan Zakaria Anam , Mahfudz Mahfudz 
Published: January 2022

Tujuan dari penelitian ini adalah untuk menganalisis pengaruh penerapan customer relatioship management (CRM), inovasi, dan penggunaan teknologi yang ada di toko grosir sebagai sebuah keunggulan bersaing terhadap kinerja bisnis toko grosir di provinsi Jawa Tengah dan DI Yogyakarta, penelitian ini memberikan pemahaman yang lebih mendalam kepada toko grosir mengenai efektifitas dan efisiensi penerapan variabel variabel tersebut terhadap kineja bisnis toko grosir dalam bersaing di industri ritel.Penelitian ini dilakukan dengan mengambil objek penelitian pada toko grosir yang menerapkan 3 variabel yang disebutkan. penelitian ini menggunakan sampel di 19 kabupaten dan 3 kotamadya di provinsi Jawa Tengah dan DI Yogyakarta. Penelitian ini menggunakan metode purposive sampling. Jumlah responden yang ditentukan sebagai sensus penelitian adalah 113 toko grosir. Teknik analisis yang dipakai untuk mengintepretasikan dan menganalisis data dalam penelitian ini adalah dengan teknik Structural Equation Modelling (SEM) dengan menggunakan software AMOS 40.Hasil pada penelitian ini menujukkan bahwa keunggulan bersaing dan CRM berpengaruh signifikan terhadap kinerja bisnis dan inovasi berpengaruh positif dan signifikan terhadap keunggulan bersaing . Hasil tersebut dapat dilihat dari pengujian hipotesis dengan menggunakan SEM yang menunjukkan nilai C.R dan P pada hipoteis 1, 2 dan 5 diterima dengan nilai C.R ≥ 1,960 dan P ≤ 0,05. Untuk hipotesis 2 digunakan tingkat signifikansi 5%. Kesimpulan dan saran yang diberikan untuk toko grosir agar semakin memperkuat pelaksanaan Customer Relationship Management, inovasi dan keunggulan bersaing melalui perbaikan manajemen dan pelayanan serta lebih secara intens lagi memanfaatkan kemajuan teknologi dalam operasional bisnis nya agar lebih cepat , efektif dan efisien dalam pelayanan yang berpengaruh terhadap kinerja bisnis.