bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of LDL to HDL ratio with new-onset atrial fibrillation after on-pump coronary artery bypass graft surgery
Authors: Yu Ming-Huan , Zhang Ren-Jian-Zhi , Yu Xin-Yi , Shi Jian-Wei , Liu Zhi-Gang 
Published: December 2022

Abstract
Objective
This study aims to analyze the association between preoperative LDL/HDL ratio and new-onset atrial fibrillation (AF) after on-pump coronary artery bypass grafting (on-pump CABG), evaluate the clinic value of preoperative LDL/HDL ratio to identify postoperative rhythm.

Methods
A retrospective study of consecutive patients (n = 2052) who underwent on-pump CABG at TEDA International Cardiovascular Hospital (Tianjin, China), from June 1, 2020, to December 30, 2021, was conducted. The association between preoperative LDL/HDL and new-onset POAF was analyzed by Lowess curve and univariate logistic regression. The receiver operating characteristic curve (ROC) and area under the curve (AUC) were used to evaluate the identification capacity of preoperative LDL/HDL level for new-onset POAF.

Results
In studied populations, the incidence of new-onset POAF was about 29.24%. The lowess curve showed that the association between preoperative LDL/HDL ratio and POAF after on-pump CABG was similar to a linear relationship. With the increasement of preoperative LDL/HDL ratio, the incidence of POAF increased simultaneously. ROC analysis showed that preoperative LDL/HDL ratio could identify postoperative arrhythmia after on-pump CABG (AUC = 0.569,95% CI = 0.529–0.608, P = 0.006) among female patients, the best preoperative LDL/HDL ratio cutoff of 2.11, which was considered a predictive factor of incident POAF, showed a sensitivity of 83.60% (95% CI = 0.775–0.886) and a specificity of 30.02% (95% CI = 0.257–0.346).

Conclusion
Preoperative LDL/HDL ratio is associated with new-onset POAF, but there is a difference in different sex. Preoperative LDL/HDL level can help to identify postoperative rhythm in females.
Transformation of Rasch model logits for enhanced interpretability
Authors: Ekstrand Joakim , Westergren Albert , Årestedt Kristofer , Hellström Amanda , Hagell Peter 
Published: December 2022

Abstract
Background
The Rasch model allows for linear measurement based on ordinal item responses from rating scales commonly used to assess health outcomes. Such linear measures may be inconvenient since they are expressed as log-odds units (logits) that differ from scores that users may be familiar with. It can therefore be desirable to transform logits into more user-friendly ranges that preserve their linear properties. In addition to user-defined ranges, three general transformations have been described in the literature: the least measurable difference (LMD), the standard error of measurement (SEM) and the least significant difference (LSD). The LMD represents the smallest possible meaningful unit, SEM relates the transformed scale values to measurement uncertainty (one unit on the transformed scale represents roughly one standard error), and LSD represents a lower bound for how coarse the transformed scale can be without loss of valid information. However, while logit transformations are relatively common in the health sciences, use of LMD, SEM and LSD transformations appear to be uncommon despite their potential role.

Methods
Logit transformations were empirically illustrated based on 1053 responses to the Epworth Sleepiness Scale. Logit measures were transformed according to the LMD, SEM and LSD, and into 0–10, 0-100, and the original raw score (0–24) ranges. These transformations were conducted using a freely available Excel tool, developed by the authors, that transforms logits into user-defined ranges along with the LMD, SEM and LSD transformations.

Results
Resulting LMD, SEM and LSD transformations ranged 0-34, 0-17 and 0-12, respectively. When considering these relative to the three user-defined ranges, it is seen that the 0-10 range is narrower than the LSD range (i.e., loss of valid information), and a 0-100 range gives the impression of better precision than there is, since it is considerably wider than the LMD range. However, the 0-24 transformation appears reasonable since it is wider than the LSD, but narrower than the LMD ranges.

Conclusions
It is suggested that LMD, SEM and LSD transformations are valuable for benchmarking in deciding appropriate ranges when transforming logit measures. This process can be aided by the Excel tool presented and illustrated in this paper.
Exploring factors that influence HRQoL for people living with Parkinson’s in one region of Ireland: A cross-sectional study
Authors: Cassidy Irene , Doody Owen , Meskell Pauline 
Published: December 2022

Abstract
Background
The diversity of symptoms associated with Parkinson’s and their impact on functioning have led to an increased interest in exploring factors that impact Health-Related Quality of Life (HRQoL). Although the experience of Parkinson’s is unique, some symptoms have a greater impact than others, e.g. depression. Moreover, as the risk of Parkinson’s increases with age, the financial and public health impact of this condition is likely to increase, particularly within the context of a globally ageing population. In Ireland, research is ongoing in the pursuit of causes and effective treatments for Parkinson’s; however, its impact on everyday living, functioning, and HRQoL is largely under-examined. This study aims to describe factors that influence HRQoL for people with Parkinson’s (PwP) in one region of Ireland.

Methods
A cross-sectional postal survey was conducted among people living with Parkinson’s (n = 208) in one area of Ireland. This survey included socio-demographic questions, Nonmotor Symptoms Questionnaire for Parkinson’s disease (NMSQuest), the Geriatric Depression Scale (GDS-15), and the Parkinson’s disease Questionnaire (PDQ-39). Statistical analysis was conducted using SPSS, IBM version 25 (SPSS Inc., Chicago, II, USA).

Results
Participants reflected a predominantly older population who were married, and lived in their own homes (91%). Participants diagnosed the longest reported poorer HRQoL regarding mobility, activities of daily living, emotional well-being, social support, cognition, communication domains and overall HRQoL. Lower HRQoL correlated with higher depression scores p < 0.001 and participants in the lower HRQoL cohort experienced 2.25 times more non-motor symptoms (NMSs) than participants with higher HRQoL. Hierarchical multiple linear regression analysis predicted Geriatric Depression Scale (GDS15) score, NMS burden, and years since diagnosis to negatively impact HRQoL. Principal component analysis (PCA) also indicated that for the population in this study, components measuring 1) independence/dependence 2) stigma 3) emotional well-being, and 4) pain were central to explaining core aspects of participants’ HRQoL.

Conclusions
Findings highlighted the negative impact of longer disease duration, NMS burden, depression, mobility impairments, and perceived dependence on HRQoL for PwP. The positive influence of perceived independence, social engagement along with close supportive relationships were also identified as key components determining HRQoL. Findings emphasised the importance of long-term healthcare commitment to sustaining social and community supports and therapeutic, rehabilitative initiatives to augment HRQoL for PwP.
Reinforcement learning using Deep $$Q$$ networks and $$Q$$ learning accurately localizes brain tumors on MRI with very small training sets
Authors: Stember J. N. , Shalu H. 
Published: December 2022

Abstract
Background
Supervised deep learning in radiology suffers from notorious inherent limitations: 1) It requires large, hand-annotated data sets; (2) It is non-generalizable; and (3) It lacks explainability and intuition. It has recently been proposed that reinforcement learning addresses all three of these limitations. Notable prior work applied deep reinforcement learning to localize brain tumors with radiologist eye tracking points, which limits the state-action space. Here, we generalize Deep Q Learning to a gridworld-based environment so that only the images and image masks are required.

Methods
We trained a Deep $$Q$$
Q
network on 30 two-dimensional image slices from the BraTS brain tumor database. Each image contained one lesion. We then tested the trained Deep Q network on a separate set of 30 testing set images. For comparison, we also trained and tested a keypoint detection supervised deep learning network on the same set of training/testing images.

Results
Whereas the supervised approach quickly overfit the training data and predictably performed poorly on the testing set (11% accuracy), the Deep $$Q$$
Q
learning approach showed progressive improved generalizability to the testing set over training time, reaching 70% accuracy.

Conclusion
We have successfully applied reinforcement learning to localize brain tumors on 2D contrast-enhanced MRI brain images. This represents a generalization of recent work to a gridworld setting naturally suitable for analyzing medical images. We have shown that reinforcement learning does not over-fit small training sets, and can generalize to a separate testing set.
Potentially preventable hospitalizations and super-utilization of inpatient services among patients with chronic kidney disease in Hawaiʻi
Authors: Prabhudesai Devashri , Davis James , Chen John J. , Lim Eunjung 
Published: December 2022

Abstract
Background
Chronic kidney disease (CKD) is linked to high morbidity and mortality and increased hospitalization burden. If appropriately managed in the outpatient setting, ambulatory care-sensitive conditions (ACSCs) do not lead to hospitalization. Hospitalizations due to ACSCs are considered as potentially preventable hospitalizations. Patients with recurrent hospitalizations are considered as super-utilizers of inpatient services. The aim of this study is to determine prevalence of potentially preventable hospitalizations and super-utilization of inpatient services among patients with CKD in Hawaiʻi.

Methods
Hawaiʻi statewide inpatient data (2015–2017) were used to identify adult CKD patients with hospitalizations during a 12-month period from the first recorded date of CKD. The associations between the potentially preventable hospitalizations and super-utilization and other key patient demographic and clinical variables (sex, age, ethnicity, insurance type, Charlson comorbidity index (CCI), county of residence, and homelessness indicator) were analyzed using bivariate analysis. Multivariable logistic regression was utilized to assess the associations between the potentially preventable hospitalizations and patient variables.

Results
Approximately 2% of patients reported potentially preventable hospitalizations, and a total of 12.3% patients reported super-utilization. Out of all CKD-specific ACSC hospitalizations, 74.2% were due to heart failure and 25.8% were due to hyperkalemia. Patients who reported super-utilization were more likely to report potentially preventable hospitalization (OR: 5.98, 95%CI: 4.50–7.93) than patients who did not report super-utilization.

Conclusion
This study showed prevalence of potentially preventable hospitalizations and high inpatient utilization among CKD patients in Hawaiʻi. Heart failure and hyperkalemia were the two major causes of CKD-specific ACSC hospitalizations in this cohort. Effective strategies should be employed to improve the outpatient CKD management to reduce hospitalizations and in turn reduce cost.
Fatal thrombolysis-related intracerebral haemorrhage associated with amyloid-β-related angiitis in a middle-aged patient – case report and literature review
Authors: Reisz Zita , Troakes Claire , Sztriha Laszlo K. , Bodi Istvan 
Published: December 2022

Abstract
Background
Amyloid-β-related angiitis (ABRA) is a rare complication of cerebral amyloid angiopathy, characterized by amyloid-β deposition in the leptomeningeal and cortical vessels with associated angiodestructive granulomatous inflammation. The clinical presentation is variable, including subacute cognitive decline, behavioural changes, headaches, seizures and focal neurological deficits, which may mimic other conditions. Here, we present a case with fatal thrombolysis-related haemorrhage associated with ABRA in a middle-aged patient.

Case presentation
A 55-year-old man was admitted to hospital with sudden onset left-sided cheek, arm and hand sensory loss, blurred vision, and worsening headache, with a National Institutes of Health Stroke Scale (NIHSS) score of 3. An acute CT head scan showed no contraindications, and therefore the decision was made to give intravenous thrombolysis. Post-thrombolysis, he showed rapid deterioration with visual disturbances, headache and confusion, and a repeat CT head scan confirmed several areas of intracerebral haemorrhage. No benefit from surgical intervention was expected, and the patient died four days after the first presentation. Neuropathological examination found acute ischemic infarcts of three to five days duration in the basal ganglia, insular cortex and occipital lobe, correlating with the initial clinical symptoms. There were also extensive recent intracerebral haemorrhages most likely secondary to thrombolysis. Furthermore, the histological examination revealed severe cerebral amyloid angiopathy associated with granulomatous inflammatory reaction, consistent with ABRA.

Conclusions
Presentation of ABRA in a middle-aged patient highlighted the difficulties in recognition and management of this rare condition. There is emerging evidence that patients with CAA may have increased risk of fatal intracerebral haemorrhages following thrombolysis. This may be further increased by a coexisting CAA-related inflammatory vasculopathy which is potentially treatable with steroid therapy if early diagnosis is made.
A pilot study of viscoelastic agent to prevent recurrent vitreous hemorrhage after vitrectomy for proliferative diabetic retinopathy
Authors: Qiu Chang-Yu , Shi Yuan-Yuan , Zhao Hong-Wei , Gong Yu-Bo , Nie Chuang , Wang Meng-Ge , Jia Rui , Zhao Jun , Wang Xin , Luo Ling 
Published: December 2022

Abstract
Background
To evaluate the possibilty of preventing recurrent vitreous hemorrhage (RVH) after vitrectomy in proliferative diabetic retinopathy (PDR) patients with unabsorbed vitreous hemorrhage (VH) by intravitreal injection of viscoelastic agent (VA) at the end of the surgery and compared its effect with triamcinolone acetonide (TA).

Methods
This was a pilot prospective, observational study. PDR patients with VH who underwent vitrectomy were assigned to 3 groups according to the tamponade applicated at the end of the surgery, including VA group (intravitreally injected 1 ml VA if the retina was prone to bleed during the operation), TA group (intravitreally injected 2 mg TA when there was much exudates), or balanced salt solution (BSS) group (no tamponade). Then postoperative follow-up was performed routinely until 6 months after surgery. The primary outcome was the incidence of RVH, secondary outcome were the best-corrected visual acuity (BCVA) and introcular pressure (IOP). Cataract formation and other complication were also assessed.

Results
A total of 68 eyes, from 68 patients, were included. 18,18,32 eyes were enrolled in the VA group, TA group and BSS group, respectively. The integral incidence of RVH after vitrectomy was 5.6%, 5.6% and 12.5% respectively (P = 0.602). There was no early RVH in VA or TA group, whereas 3 early RVHs were identified in BSS group, however there was no significant difference (P = 0.171). Every group had one late RVH case. In all groups, final BCVA showed significant improvement compared to baseline. BCVA at any postoperative visit showed no significant differences among 3 groups. Mean IOP was higher 1 week after surgery in VA group compared with the other groups; however, in other times the differences were not significant. No cataract formation and other complication was noted in 3 groups.

Conclusion
Intravitreal injection of VA or TA at the end of vitrectomy for PDR patients with unabsorbed VH tend to reduce the incidence of early RVH after vitrectomy similarly. As VA was preferred to applicate in the eyes that were prone to bleed, intravitreal injection of VA at the end of vitrectomy might be a promising method for preventing RVH in PDR patients.
Corneal epithelial ingrowth after perforating corneal injury: a case report
Authors: Quintin Adrien , Hamon Loïc , Flockerzi Fidelis A. , Schlötzer-Schrehardt Ursula , Dias Blak Matthias , Seitz Berthold 
Published: December 2022

Abstract
Background
Epithelial ingrowth is a rare complication after ocular perforation and can become manifest many years after the primary trauma.

Case presentation
A 49-year-old patient presented with a positive Seidel test of unclear origin at her left eye, as well as a sharply defined anterior-stromal corneal scar at both eyes. Prior operations included a bilateral laser-assisted blepharoplasty 3 months earlier. The patient indicated to have been on holiday to France 5 months earlier, during an ongoing oak processionary moth caterpillars infestation.
The examination using confocal microscopy confirmed a corneal perforation at the left eye and revealed corneal epithelial ingrowth capped with scarred stroma in both eyes. We performed a penetrating keratoplasty at the left eye. The scarred and perforated host cornea was divided into 4 pieces for further investigation: microbiology (negative), virology (negative), histology and transmission electron microscopy (TEM). Histology revealed differently structured epithelium, centrally inverted into the stroma through defects in Bowman’s layer. TEM revealed full thickness corneal perforation with an epithelial plug extending to the lower third of the cornea, but without evidence of epithelial cell migration into the anterior chamber.
Our differential diagnosis of the unclear positive Seidel test with epithelial ingrowth was as follows: (1) corneal perforation by hairs of the oak processionary moth caterpillar, although no hairs could be found histologically; (2) corneal perforation during laser-assisted blepharoplasty, which may be supported by the presence of pigmented cells on the posterior surface of Descemet´s membrane, pointing to a possible iris injury.

Conclusion
Consequently, we highlighted that contact lenses can be useful, safe and inexpensive protective devices in upper eyelid procedures to protect the cornea against mechanical iatrogenic trauma.
The mediating and moderating role of psychological resilience between occupational stress and mental health of psychiatric nurses: a multicenter cross-sectional study
Authors: Chen Shu-Yan , Yan Shi-Rui , Zhao Wei-Wei , Gao Ying , Zong Wei , Bian Cheng , Cheng Yin , Zhang Yan-Hong 
Published: December 2022

Abstract
Background
The particular occupational stress of psychiatric nurses has a negative impact on their mental health. There is evidence that psychological resilience can promote mental health; however, the relationship between resilience in occupational stress and mental health of psychiatric nurses is unclear, and mental health was assessed from a psychopathological perspective, neglecting the role of positive psychology. Therefore, this study was based on a dual-factor model of mental health, describing mental health in terms of both positive well-being and psychiatric symptoms. We aimed to investigate the level of psychiatric nurses' mental health and whether resilience plays a mediating or moderating role between occupational stress and mental health in psychiatry nurses.

Methods
A cross sectional survey of 450 psychiatric nurses in five hospitals in Jiangsu Province was conducted using a convenience sampling method, of which 413 were valid questionnaires with an effective rate of 91.8%. The evaluation included the Chinese Nurses’ Stress Scale, the Connor-Davidson Resilience Scale, the Warwick-Edinburgh Mental Well-being Scale, and the General Health Questionnaire. Descriptive and Spearman correlation analyses were performed using SPSS25.0 while mediating and moderating effects were performed using SmartPLS3.0.

Results
Based on a dual-factor model of mental health, this study found that psychiatric nurses had a low general state of mental health, with 54.5% positive mental health, 7% vulnerable, 21.8% symptomatic but content, and 16.7% completely troubled. In addition, we found that resilience plays a mediating role in stress and mental health [β = -0.230, 95% CI of (-0.310, -0.150)] and does not play a moderating role [β = -0.018, 95%CI (-0.091, 0.055)].

Conclusions
Psychiatric nurses are in a poor state of mental health, and psychological resilience partly mediates occupational stress and mental health. This study suggests that attention should be paid to both positive and negative aspects of psychiatric nurses' mental health, and strategies should be developed to reduce occupational stress and develop psychological resilience.
Physical impairments among adults in Denmark: a register-based study
Authors: Nikolajsen Helene , Larsen Camilla Marie , Holsgaard-Larsen Anders , Juul-Kristensen Birgit , Hestbaek Lise 
Published: December 2022

Abstract
Background

Knowledge of the prevalence and socio-demographic characteristics of physical impairments is limited. This study aimed to determine the prevalence of physical impairments among adults in Denmark, both in total and according to nine common diagnostic subgroups, describe the socio-demographic and socio-economic profile, and compare the data with those of the general adult population.

Methods
This descriptive, cross-sectional, register-based study evaluated the general socio-demographic and socio-economic variables, including sex, age, geographical region, origin, educational level, occupation, marital status, and disability level, of adults with physical impairments extracted by diagnosis from the Danish National Patient Register and Statistics Denmark by 31 December 2018. These data were compared with those of the general adult population in Denmark extracted from Statistics Denmark by January 2019.

Results
In total, 606,857 adults with physical impairments were identified. Of the nine selected diagnoses, osteoarthritis (69.4%) was the most prevalent, followed by acquired brain injury (29.0%), rheumatoid arthritis (6.7%), multiple sclerosis (2.6%), spinal cord injury (1.5%), cerebral palsy (1.2%), amputation (0.7%), muscular dystrophy (0.5%), and poliomyelitis (< 0.1%). There were large variations in the socio-demographic and socio-economic profile between the nine diagnostic subgroups. The adults with physical impairments were more often women, were older, were less often immigrants and employed adults, had a lower educational level, and were more commonly married than the general adult population. Only the geographical region did not differ.

Conclusion
The nine subgroups with diagnoses related to the musculoskeletal system represent 13% of the adult Danish population. The socio-demographic and socio-economic profile varied largely between the nine diagnostic subgroups, and almost all variables differed significantly between adults with physical impairments and the general adult population in Denmark. These findings reveal patterns and trends on socio-demographic and socio-economic variables essential for future planning at a societal level, including the healthcare and social sectors.