bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute kidney injury, the present on admission (POA) indicator and sex disparities: observational study of inpatient real-world data in a Swiss tertiary healthcare system. Explorative analysis
Authors: Triep Karen , Musy Sarah N , Simon Michael , Endrich Olga 
Published: February 2024

BackgroundRegarding kidney disease (KD), sex differences in epidemiology and clinical relevance have been reported. Related to absolute and relative changes of baseline creatinine, different criteria for staging may induce underdiagnosis or overdiagnosis related to sex. At the largest Swiss provider of inpatient acute healthcare, a clinic decision support algorithm ensures exact staging of KD (2012 KDIGO Kidney Disease Improving Global Outcomes Clinical Practice Guideline). Coding of the indicator ‘Present On Admission’ (POA) was introduced at this institution in 2018 to flag postadmission conditions.ObjectiveThe explorative analysis aimed at differences in diagnosis groups. Defined indicators and the distribution of stages in acute kidney injury (AKI) were analysed using the POA flag. Sex differences were reported.MethodsRetrospective observational study. Explorative analysis. Routinely collected health data, 2019 and 2020 (121 757 cases) on the patient history and intensive care treatment duration, comorbidity levels, coded diagnoses, age and sex.Software and statistic: program R, V.4.1.1, SD; median, IQR; prop.test; standardised mean difference.ResultsThe reporting of postadmission diagnoses showed more interhospital transfers, more intensive care stays, higher scores of severity and treatment intensity, more often mechanical ventilation, a higher age, a higher number of diagnoses, a higher complexity level of the related cases and mortality. This observation could be made to a lesser degree for the female population. However, for the female population mortality was higher (stage III AKI 41.6%).ConclusionUsing the POA flag, the results reflect the clinical situation of complications and comorbidities evolving unexpectedly. As our results show sex differences, that is, a lower morbidity of female patients for each stage, but a higher mortality, a deeper evaluation of the implied sex differences in staging of KD should follow.The general results confirm the necessity of a diagnosis-onset reporting in health statistics.
Estimating rare disease prevalence and costs in the USA: a cohort study approach using the Healthcare Cost Institute claims data
Authors: Cutillo Christine M , Tisdale Ainslie , Baghbanzadeh Mahdi , Crandall Keith A , Stidd Reva L , Khural Manpreet S , Hartman Laurie J , Greenberg Jeff , Zhang Kevin B , Rahnavard Ali 
Published: February 2024

Objective
The study capitalised on national insurance claims data to gather information on patient characteristics and associated costs to better understand the diagnosis and treatment of rare diseases (RDs).

Materials and methods
Data from the Healthcare Cost Institute (HCCI) data enclave were analysed using R statistical software and filtered by the International Classification of Diseases, 10th edition (ICD-10), current procedural terminology codes and the National Drug Code associated with 14 RDs and disease-modifying therapy options. Data were aggregated by prevalence, costs, patient characteristics and effects of treatment modification.

Results
The prevalence and costs of RDs in the HCCI commercial claims database varied significantly across the USA and between urban and rural areas. Pharmacy costs increased when a new treatment was initiated, while non-pharmacy costs decreased.

Discussion
Prevalence and cost estimations are highly variable due to the small number of patients with RDs, and the lack of a national healthcare database limits inferences for such patient populations. Accurate assessments require a diverse population, which can likely be achieved by analysing multiple databases. RDs face challenges in prevalence estimation due to a lack of specific disease coding and a small patient population, compounded by issues like data standardisation and privacy concerns. Addressing these through improved data management in healthcare systems, increased research and education will lead to better diagnosis, care management and quality of life for patients with RD.

Conclusion
Data on patients with RD in the HCCI database were analysed for prevalence, costs, patient characteristics and treatment modification effects. Significant heterogeneity in each of these factors was found across RDs, geography and locality (eg, urban and rural). Building capabilities to use machine learning to accelerate the diagnosis of RDs would vastly improve with changes to healthcare data, such as standardising data input, linking databases, addressing privacy issues and assigning ICD-10 codes for all RDs, resulting in more robust data for RD analytics.
Mental health effects of working as a legal professional in the field of asylum law: a systematic review
Authors: Holt Leah , Mulcaire Jessie , O'Driscoll Ciarán , Zard Sana , Brady Francesca 
Published: February 2024

AimsLegal professionals work closely with asylum seekers at many points during an asylum claim. While there is an increasing literature examining the mental health effects of working with traumatised populations, there has been limited evidence focusing on the field of asylum law. This review aims to synthesise the current qualitative and quantitative literature on the mental health effects of working in asylum law.MethodA systematic search from inception to 24 August 2023 was completed on the following databases: Web of Science, PsycINFO, MEDLINE, PubMed, SCOPUS, Westlaw UK, Index to Foreign Legal Periodicals and Index to Legal Periodicals and Books. The search retrieved 11 studies (6 qualitative, 3 quantitative and 2 mixed methods). A thematic synthesis was completed for the qualitative research and a narrative synthesis was completed for the quantitative research, before the findings were integrated into a combined synthesis.ResultsFour main themes and 13 subthemes were generated by the qualitative research. The main themes were as follows: emotional labour, working in a broken system, emotions do not mix with law and detachment. The quantitative synthesis found a variety of measures used in the literature, indicating that common mental health concerns, such as burn-out, depression, anxiety, post-traumatic stress disorder and secondary trauma symptoms, are present across this professional group. The synthesis also provides preliminary findings relating to possible predictors of poor mental health.ConclusionsDespite limited evidence and methodological flaws in the literature, this review indicates that legal professionals are exposed to traumatised clients and difficult working conditions, both of which can negatively impact mental health. It also highlights a number of factors which may predict or perpetuate difficulties. Clinical implications, limitations and suggestions for future research are discussed.
Embodiment of discrimination: a cross-sectional study of threats, humiliating treatment and ethnic discrimination in relation to somatic health complaints among Sámi in Sweden
Authors: San Sebastian Miguel , Gustafsson Per Erik , Stoor Jon Petter Anders 
Published: February 2024

BackgroundEthnic discrimination is acknowledged as a social determinant of health for Indigenous populations worldwide. This study aimed to investigate embodiment of perceived ethnic discrimination among the Sámi population in Sweden.MethodsA population-based health study was conducted among the Sámi population aged 18–84 years in 2021. Perceived discrimination was assessed by three variables: exposure to threat, humiliation treatment and ethnic discrimination. To capture current physical health, complaints of headache, back pain, stomach pain, sleeping problems, dizziness and tiredness were used. An overall somatic complaints score was created by summing up the six individual symptoms. The magnitude of the association between the independent variables and the outcomes was summarised with the β coefficients and prevalence ratios using 95% credible intervals (95% CrI) for inferential purposes.ResultsOverall, 4.3% reported to have been exposed to threat, 26.1% to humiliation and 11.2% and 32.3% to ethnic discrimination in the last 12 months and beyond 12 months, respectively. After mutual adjustment, threat (β=1.25; 95% CrI=0.88 to 1.60), humiliation (β=1.29; 95% CrI: 1.14 to 1.44) and the two categories of discrimination (β=0.92; 95% CI: 0.64 to 1.21 in the last 12 months and β=0.68; 95% CI: 0.54 to 0.83 beyond) remained significantly associated to the overall somatic complaints score. Similar results were found for individual complaints.ConclusionsThis study has shown a strong relationship between different expressions of perceived ethnic discrimination and a series of somatic complaints among the Sámi in Sweden. Efforts to alleviate interpersonal and institutional discrimination against the Sámi would contribute to improve their health.
Do pulmonary rehabilitation programmes improve outcomes in patients with COPD posthospital discharge for exacerbation: a systematic review and meta-analysis
Authors: Jenkins Alex R , Burtin Chris , Camp Pat G , Lindenauer Peter , Carlin Brian , Alison Jennifer A , Rochester Carolyn , Holland Anne E 
Published: February 2024

IntroductionPrevious systematic reviews have provided heterogeneous and differing estimates for the efficacy of pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease (COPD). The aim of this review was to examine the efficacy of pulmonary rehabilitation programmes initiated within 3 weeks of hospital discharge following an exacerbation of COPD.MethodsAn update of a previous Cochrane review was undertaken using the Cochrane Airways Review Group Specialised Register. Searches were conducted from October 2015 to August 2023 for studies that initiated pulmonary rehabilitation within 3 weeks of hospital discharge. Studies assessing the impact of solely inpatient pulmonary rehabilitation were excluded. Forest plots were generated using a generic inverse variance random effects method.ResultsSeventeen studies were included. Posthospital discharge pulmonary rehabilitation reduced hospital re-admissions (OR 0.48, 95% CI 0.30 to 0.77, I2=67%), improved exercise capacity (6 min walk test, mean difference (MD) 57 m, 95% CI 29 to 86, I2=89%; incremental shuttle walk test, MD 43 m, 95% CI 6 to 79, I2=81%), health-related quality of life (St. George’s Respiratory Questionnaire, MD −8.7 points, 95% CI −12.5 to −4.9, I2=59%; Chronic Respiratory Disease Questionnaire (CRQ)-emotion, MD 1.0 points, 95% CI 0.4 to 1.6, I2=74%; CRQ-fatigue, MD 0.9 points, 95% CI 0.1 to 1.6, I2=91%), and dyspnoea (CRQ-dyspnoea, MD 1.0 points, 95% CI 0.3 to 1.7, I2=87%; modified Medical Research Council Dyspnoea Scale, MD −0.3 points, 95% CI −0.5 to −0.1, I2=60%). Significant effects were not observed for CRQ-mastery, COPD assessment test, EuroQol-5 Dimension-5 Level and mortality. No intervention-related adverse events were reported.DiscussionPulmonary rehabilitation delivered posthospital discharge for exacerbation of COPD results in a reduction in hospital re-admissions and improvements in exercise capacity, health-related quality of life and dyspnoea in the absence of any intervention-related adverse events.Trial registration numberCRD42023406397.
Out-of-distribution Detection in Dependent Data for Cyber-physical Systems with Conformal Guarantees
Authors: Kaur Ramneet , Yang Yahan , Sokolsky Oleg , Lee Insup 
Published: February 2024

Uncertainty in the predictions of learning-enabled components hinders their deployment in safety-critical cyber-physical systems (CPS). A shift from the training distribution of a learning-enabled component (LEC) is one source of uncertainty in the LEC’s predictions. Detection of this shift or out-of-distribution (OOD) detection on individual datapoints has therefore gained attention recently. But in many applications, inputs to CPS form a temporal sequence. Existing techniques for OOD detection in time-series data for CPS either do not exploit temporal relationships in the sequence or do not provide any guarantees on detection. We propose using deviation from the in-distribution temporal equivariance as the non-conformity measure in conformal anomaly detection framework for OOD detection in time-series data for CPS. Computing independent predictions from multiple conformal detectors based on the proposed measure and combining these predictions by Fisher’s method leads to the proposed detector CODiT with bounded false alarms.
CODiT performs OOD detection on fixed-length windows of consecutive time-series datapoints by using Fisher value of the input window. We further propose performing OOD detection on real-time time-series traces of variable lengths with bounded false alarms. This can be done by using CODiT to compute Fisher values of the sliding windows in the input trace and combining these values by a merging function. Merging functions such as Harmonic Mean, Arithmetic Mean, Geometric Mean, Bonferroni Method, and so on, can be used to combine Fisher values of the sliding windows in the input trace, and the combined value can be used for OOD detection on the trace with bounded false alarm rate guarantees.

We illustrate the efficacy of CODiT by achieving state-of-the-art results in two case studies for OOD detection on fixed-length windows. The first one is on an autonomous driving system with perception (or vision) LEC. The second case study is on a medical CPS for walking pattern or GAIT analysis where physiological (non-vision) data is collected with force-sensitive resistors attached to the subject’s body. For OOD detection on variable length traces, we consider the same case studies on the autonomous driving system and medical CPS for GAIT analysis. We report our results with four merging functions on the Fisher values computed by CODiT on the sliding windows of the input trace. We also compare the false alarm rate guarantees by these four merging functions in the autonomous driving system case study. Code, data, and trained models are available at
https://github.com/kaustubhsridhar/time-series-OOD
.
Stromal Signals Dominate Gene Expression Signature Scores That Aim to Describe Cancer Cell–intrinsic Stemness or Mesenchymality Characteristics
Authors: Kreis Julian , Aybey Bogac , Geist Felix , Brors Benedikt , Staub Eike 
Published: February 2024

Abstract

Epithelial-to-mesenchymal transition (EMT) in cancer cells confers migratory abilities, a crucial aspect in the metastasis of tumors that frequently leads to death. In multiple studies, authors proposed gene expression signatures for EMT, stemness, or mesenchymality of tumors based on bulk tumor expression profiling. However, recent studies suggested that noncancerous cells from the microenvironment or macroenvironment heavily influence such signature profiles. Here, we strengthen these findings by investigating 11 published and frequently referenced gene expression signatures that were proposed to describe EMT-related (EMT, mesenchymal, or stemness) characteristics in various cancer types. By analyses of bulk, single-cell, and pseudobulk expression data, we show that the cell type composition of a tumor sample frequently dominates scores of these EMT-related signatures. A comprehensive, integrated analysis of bulk RNA sequencing (RNA-seq) and single-cell RNA-seq data shows that stromal cells, most often fibroblasts, are the main drivers of EMT-related signature scores. We call attention to the risk of false conclusions about tumor properties when interpreting EMT-related signatures, especially in a clinical setting: high patient scores of EMT-related signatures or calls of “stemness subtypes” often result from low cancer cell content in tumor biopsies rather than cancer cell–specific stemness or mesenchymal/EMT characteristics.

Significance:
Cancer self-renewal and migratory abilities are often characterized via gene module expression profiles, also called EMT or stemness gene expression signatures. Using published clinical tumor samples, cancer cell lines, and single cancer cells, we highlight the dominating influence of noncancer cells in low cancer cell content biopsies on their scores. We caution on their application for low cancer cell content clinical cancer samples with the intent to assign such characteristics or subtypes.
Association of Socioeconomic Status With Life's Essential 8 in the National Health and Nutrition Examination Survey: Effect Modification by Sex
Authors: Williams Amaris , Nolan Timiya S. , Luthy Jacsen , Brewer LaPrincess C. , Ortiz Robin , Venkatesh Kartik K. , Sanchez Eduardo , Brock Guy N. , Nawaz Saira , Garner Jennifer A. , Walker Daniel M. , Gray Darrell M. , Joseph Joshua J. 
Published: February 2024

Background
Higher scores for the American Heart Association Life's Essential 8 (LE8) metrics, blood pressure, cholesterol, glucose, body mass index, physical activity, smoking, sleep, and diet, are associated with lower risk of chronic disease. Socioeconomic status (SES; employment, insurance, education, and income) is associated with LE8 scores, but there is limited understanding of potential differences by sex. This analysis quantifies the association of SES with LE8 for each sex, within Hispanic Americans, non‐Hispanic Asian Americans, non‐Hispanic Black Americans, and non‐Hispanic White Americans.

Methods and Results

Using cross‐sectional data from the National Health and Nutrition Examination Survey, years 2011 to 2018, LE8 scores were calculated (range, 0–100). Age‐adjusted linear regression quantified the association of SES with LE8 score. The interaction of sex with SES in the association with LE8 score was assessed in each racial and ethnic group. The US population representatively weighted sample (13 529 observations) was aged ≥20 years (median, 48 years). The association of education and income with LE8 scores was higher in women compared with men for non‐Hispanic Black Americans and non‐Hispanic White Americans (
P
for all interactions <0.05). Among non‐Hispanic Asian Americans and Hispanic Americans, the association of SES with LE8 was not different between men and women, and women had greater LE8 scores than men at all SES levels (eg, high school or less, some college, and college degree or more).

Conclusions
The factors that explain the sex differences among non‐Hispanic Black Americans and non‐Hispanic White Americans, but not non‐Hispanic Asian Americans and Hispanic Americans, are critical areas for further research to advance cardiovascular health equity.
Associations of Abdominal Muscle Density and Area and Incident Cardiovascular Disease, Coronary Heart Disease, and Stroke: The Multi‐Ethnic Study of Atherosclerosis
Authors: Larsen Britta , Bellettiere John , Allison Matthew , Ryu Rita , Tam Rowena M. , McClelland Robyn L. , Miljkovic Iva , Vella Chantal , Ouyang Pamela , Criqui Michael , Unkart Jonathan 
Published: February 2024

Background
Muscle density is inversely associated with all‐cause mortality, but associations with cardiovascular disease (CVD) risk are not well understood. This study evaluated the association between muscle density and muscle area and incident total CVD, coronary heart disease (CHD), and stroke in diverse men and women.

Methods and Results

Adult participants (N=1869) in the Multi‐Ethnic Study of Atherosclerosis Ancillary Body Composition Study underwent computer tomography scans of the L2‐L4 region of the abdomen. Muscle was quantified by density (Hounsfield units) and area in cm
2
. Sex‐stratified Cox proportional hazard models assessed associations between incident total CVD, incident CHD, and incident stroke across sex‐specific percentiles of muscle area and density, which were entered simultaneously into the model. Mean age for men and women at baseline were 64.1 and 65.1 years, respectively, and median follow‐up time was 10.3 years. For men, associations between muscle density and incident CVD were inverse but not significant in fully adjusted models (
P
trend=0.15). However, there was an inverse association between density and CHD (
P
trend=0.02; HR, 0.26 for 95th versus 10th percentile), and no association with stroke (
P
trend=0.78). Conversely, for men, there was a strong positive association between muscle area and incident CVD (HR, 4.19 for 95th versus 10th percentile;
P
trend<0.001). Associations were stronger for CHD (HR, 6.18 for 95th versus 10th percentile;
P
trend<0.001), and null for stroke (
P
trend=0.67). Associations for women were mostly null.

Conclusions
For men, abdominal muscle density is associated with lower CHD risk, whereas greater muscle area is associated with markedly increased risk of CHD.
Long‐Term Functional Outcome in Patients With Isolated Thalamic Stroke: The KOSCO Study
Authors: Lee Ho Seok , Sohn Min Kyun , Lee Jongmin , Kim Deog Young , Shin Yong‐Il , Oh Gyung‐Jae , Lee Yang‐Soo , Joo Min Cheol , Lee So Young , Song Min‐Keun , Han Junhee , Ahn Jeonghoon , Kim Dae Hyun , Kim Yun‐Hee , Chang Won Hyuk 
Published: February 2024

Background
Information on the long‐term prognosis in patients with isolated thalamic stroke is sparse. We report the functional outcomes of patients with thalamic stroke up to 24 months from the KOSCO (Korean Stroke Cohort for Functioning and Rehabilitation) study.

Methods and Results

Isolated thalamic stroke was defined as the presence of lesions solely in the thalamus, excluding cases with lesions in other brain parenchyma areas apart from the thalamus, as identified by brain magnetic resonance imaging or computed tomography scans. The Fugl‐Meyer Assessment, the Functional Ambulatory Category, the Korean Mini‐Mental State Examination, the American Speech‐Language‐Hearing Association National Outcome Measurement System Swallowing Scale, and the short version of the Korean Frenchay Aphasia Screening Test were used to assess physical impairment. The Functional Independence Measure and modified Rankin Scale were used to assess functional outcomes. All measurements were conducted up to 24 months poststroke. A total of 297 patients were included, consisting of 235 with ischemic and 62 with hemorrhagic stroke. Except for the Functional Ambulatory Category and Functional Independence Measure, all physical impairments showed significant improvement up to 3 months poststroke (
P
<0.001) and reached a plateau. The Functional Ambulatory Category and Functional Independence Measure scores continued to improve up to 12 months poststroke (
P
<0.05) and reached a plateau. At 7 days poststroke, 47.5% of patients had no disability (modified Rankin Scale score<2), whereas at 24 months poststroke, 76.4% of patients had no significant disability.

Conclusions
Patients showed rapid recovery from physical impairment up to 3 months poststroke, with additional improvements in ambulatory function and independence observed up to 12 months poststroke. Additionally, relatively favorable long‐term functional prognosis at 24 months after onset was demonstrated. These results could provide insights into the proper management regarding functional outcomes of patients with isolated thalamic stroke.