bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic accuracy of linked administrative data for dementia diagnosis in community-dwelling older men in Australia
Authors: Chow Eric P. F. , Hsu Benjumin , Waite Louise M. , Blyth Fiona M. , Handelsman David J. , Le Couteur David G. , Naganathan Vasi , Stanaway Fiona F. 
Published: November 2022

Abstract
Background
Routinely collected health administrative data can be used to estimate the prevalence or incidence of dementia at a population level but can be inaccurate. This study aimed to examine the accuracy of hospital and death data for diagnosing dementia compared with a clinical diagnosis in community dwelling older men in Australia.

Methods
We performed a retrospective analysis of the Concord Health and Ageing in Men Project (CHAMP) in Sydney, Australia. Of the 1705 men aged ≥70 years in the CHAMP study, 1400 had available linked administrative data records from 1 year prior to 1 year post the date of clinical dementia diagnosis. The primary outcome was the accuracy of dementia diagnosis using linked administrative data records compared to clinical dementia diagnosis. The linked data diagnosis was based on hospital and death records for the 1 year pre and post the clinical diagnosis. Clinical dementia diagnosis was a two-stage process with initial screening, followed by clinical assessment for those meeting a validated cut-off. A final clinical diagnosis of dementia based on the Diagnostic and Statistical Manual of Mental Disorders (4th edition) criteria was reached by a consensus panel.

Results
Administrative data identified 28 participants as having dementia, compared to 88 identified through clinical assessment. Administrative data had a sensitivity of 20% (95% CI: 13–30%, 18/88), specificity of 99% (95% CI: 99–100%, 1301/1312), positive predictive value (PPV) of 62% (95% CI: 44–77%), negative predictive value of 95% (95% CI: 94–95%), positive likelihood ratio of 24.4 (95% CI: 11.9–50.0) and negative likelihood ratio of 0.80 (0.72–0.89).

Conclusions
Administrative hospital and death data has limited accuracy for dementia diagnosis with poor sensitivity and PPV. The prevalence of dementia is likely underestimated using hospital and deaths data.
The values of elastic quantitative and semi-quantitative indexes measured from different frequencies in the establishment of prediction models for breast tumor diagnosis
Authors: Xie Xiao , Ma Yibo , Xing Xiaoxiao , Zhou Haixia , Liu Shuiqing , Zhang Yanyan , Xu Min 
Published: November 2022

Abstract
Objective
To obtain the elastic quantitative and semi-quantitative indexes of solid breast masses using ultrasound linear array probes with two different frequencies, and to construct prediction models and evaluate their diagnostic values.

Methods
A total of 92 patients who were scheduled for surgical treatment on solid breast masses were enrolled in this study. Linear array probes with two frequencies, 9-3 MHz (L9 group) and 14-5 MHz (L14 group), were used for sound touch elastography and strain elastography before surgery, and the maximum elasticity value (Emax), average elasticity value (Emean), minimum elasticity value (Emin), standard deviation (SD)(in kPa), elasticity ratio (E), and strain ratio to fat (SRf) were recorded and calculated for the breast mass (A) and surrounding tissues (Shell). The elastic characteristic indexes of the L9 group and L14 group were compared, and the prediction models of these two groups were constructed using Logistic regression method.

Results
The diagnostic performance of the prediction model based on L9 group was better than the model based on L14 group (AUC: 0.904 vs. 0.810, P = 0.0343, z = 2.116) and the best single index EMax-shell-L9 (P = 0.0398, z = 2.056). The sensitivity of L9 based model was 85.19% and the specificity was 84.21%.

Conclusion
The prediction model based on quantitative and semi-quantitative elastic ultrasound indexes from L9-3 probe exhibited better performance, which could improve the diagnostic accuracy for malignant breast tumors.
Validation of the generalized anxiety disorder screener (GAD-7) in Cypriot pregnant and postpartum women
Authors: Vogazianos Paris , Motrico Emma , Domínguez-Salas Sara , Christoforou Andri , Hadjigeorgiou Eleni 
Published: November 2022

Abstract
Background
Anxiety is increasingly acknowledged as a common mental health issue during the perinatal period. Its prevalence as well as the associated adverse effects constitute screening imperative. This study evaluates the psychometric properties and underlying factor structures of a Greek version of GAD-7 among pregnant and postpartum women (up to 6 months) in Cyprus.

Methods
This study was conducted from June to December 2020. A total of 457 Cypriot women in the perinatal period (222 pregnant and 235 postpartum) were surveyed. The assessment included anxiety (GAD-7) and depression (EPDS), and psychosocial factors related with anxiety. The internal consistency and factor structure of GAD-7 were evaluated using reliability coefficients, Cronbach’s Alpha and McDonald's Omega, and factor analysis, both Exploratory as well as Confirmatory.

Results
GAD-7 demonstrated good internal consistency (α = 0.907; Ω = 0.909). Horn's parallel analysis indicated a single factor as the most appropriate. CFA using the standard ML method indicated a good model fit, χ2 = 21.207, p = 0.096; CFI = 0.999; SRMR = 0.027. More studies are needed to determinate the cut-off point and the maximisation of the scale’s sensitivity and specificity in pregnant and postpartum Greek Cypriot women.

Conclusions
GAD-7 is a valid and reliable measure and healthcare professionals should utilize GAD-7 as a standard instrument for the screening of anxiety symptoms in pregnant and postpartum Greek Cypriot women.
Nomogram-based development and evaluation for predictions of 30-day and 1-year survival in patients with spontaneously ruptured hepatocellular carcinoma
Authors: Wang Peng , Yang Shuping , Li Chao , Han Xiangjun , Hong Duo , Shao Haibo 
Published: November 2022

Abstract
Background
Accurately predicting the prognosis of patients with spontaneously ruptured hepatocellular carcinoma (HCC) is crucial for effective clinical management. The aim of the present study was to establish and evaluate prediction models for 30-day and 1-year survival in patients with spontaneously ruptured HCC.

Methods
A total of 118 patients with spontaneous rupture HCC were enrolled. Univariate and multivariate analyses were performed using logistic-regression model and Cox proportional-hazard model. The identified indicators were used to establish prediction models, the performance of which we compared with those of commonly used liver disease scoring models. The survival possibilities of different risk categories were calculated using the newly developed models.

Results
Largest tumor size (LTS), serum albumin (ALB), total bilirubin (TBil), and serum creatinine were identified as independent predictors, which were used to establish a 30-day survival prediction model. LTS, BCLC staging, ALB, TBil, hepatectomy at rupture, and TACE during follow-up were identified as independent predictors of 1-year survival model. The 30-day survival model had sensitivity of 79.3%, specificity of 87.1%, and an AUC of 0.879, exhibiting better predictive performance than scores for Chronic Liver Failure Consortium Acute Decompensation score (CLIF-C ADs) and Model for End-stage Liver Disease (MELD). The 1-year survival model had sensitivity of 66.7%, specificity of 94.6%, and an AUC of 0.835, showing better predictive performance than Albumin–Bilirubin (ALBI), Child–Pugh, CLIF-C ADs, and MELD. After stratification, survival possibilities were 90.9 and 21.1% in low- and high-risk groups within 30 days, respectively, and 43.90, 4.35%, and 0 in low-, intermediate-, and high-risk groups at 1 year, respectively.

Conclusions
The established models exhibited good performance in predicting both 30-day and 1-year survival in patients with spontaneously ruptured HCC.
Healthy physical education curriculum model and students’ extracurricular sports participation ——test based on the trans-contextual model of motivation
Authors: Hao Xiaoliang , Yang Yunyun 
Published: November 2022

Abstract
Background
In recent years, the mental health level and physical activity level of Chinese teenagers are not ideal, and all sectors of society are actively reversing this bad situation. The purpose of this study is to test the influence of healthy physical education curriculum model on middle school students’ extracurricular sports participation based on the trans-contextual model of motivation (TCM).

Methods
The trial adopts quasi-experimental design comparing equivalent groups. The experimental group adopted the healthy physical education curriculum model in physical education (PE), and the control group adopted the technical-traditional teaching. During the 12 weeks intervention, 327 junior school freshmen completed the test of TCM variables four times as the pre-test, test 2, test 3 and post-test of this experimental study.

Results
After the intervention, students’ perceived need support in PE, autonomous motivation in PE, autonomous motivation in leisure time (LT)and the amount of extracurricular sports activities in the experimental group have increased significantly. The perceived need support of experimental group students can predict autonomous motivation in PE positively (β = 0.385, P<.001); Autonomous motivation in PE can predict autonomous motivation in LT positively (β = 0.462, P<.001); Autonomous motivation in LT can predict the intention of extracurricular sports participation positively, and the direct effect was significant (β = 0.172, P<.01), the total indirect effect was significant (β = 0.382, P<.001), the indirect effect of subjective norms was not significant (P>.05); Extracurricular sports participation intention can predict the amount of extracurricular sports activities positively (β = 0.327, P<.001).

Conclusions
The structural characteristics of healthy physical education curriculum model provide need support for students’ learning, improve students’ autonomous motivation in and out of PE, and finally promote students’ participation in extracurricular sports.
Parental migration and left-behind children in Georgia – school teachers’ experience and perception: a qualitative study
Authors: Antia Khatia , Rodoreda Astrid Berner , Winkler Volker 
Published: November 2022

Abstract
Introduction
Georgia, like other Eastern European countries, showed a dramatic increase of international labour emigration after becoming independent in 1991. The collapse of the Soviet Union caused economic instability, unemployment and poverty resulting in labour migration. Since then, thousands of children have been left behind in the care of extended family members while their parents work abroad. The aim of this study is to explore schoolteachers’ perceptions on parental migration and left-behind children (LBC) in Georgia as schoolteachers are the main contact persons for LBC and their caregivers.

Methods
We conducted six focus-group discussions with public school teachers, namely class-tutors and six in-depth interviews with school principals from two migrant sending regions. We applied reflexive thematic analysis to systematically analyse the data and identify main and sub-themes. The contextual model of family stress underpins this study.

Results
We identified the following themes expressed by both, teachers, and school principals: social and economic impact of migrant labour and relationships between schools and migrant families. School teachers and principals acknowledged some positive aspects of migrant labour, but primarily perceived parental migration as a negative experience for children leading to problems in mental health, well-being, and academic performance. Structural factors, lack of support and lack of community involvement were expressed to further worsen the situation. Teachers saw themselves as one of the main supporters for LBC while they described the role of caregivers ranging from caring to unhelpful or even destructive. School principals stated mitigating the situation by regular meetings with class tutors, extra-tutoring for LBC, psychological counselling, and developing/enacting internal guidelines.

Conclusions
Our findings suggest that LBCs and transnational families could benefit from the provision of psychological services at schools.
Stress in surgical educational environments: a systematic review
Authors: Tjønnås Maria Suong , Guzmán-García Carmen , Sánchez-González Patricia , Gómez Enrique Javier , Oropesa Ignacio , Våpenstad Cecilie 
Published: November 2022

Abstract
Background
The effects of stress on surgical residents and how stress management training can prepare residents to effectively manage stressful situations is a relevant topic. This systematic review aimed to analyze the literature regarding (1) the current stress monitoring tools and their use in surgical environments, (2) the current methods in surgical stress management training, and (3) how stress affects surgical performance.

Methods
A search strategy was implemented to retrieve relevant articles from Web of Science, Scopus, and PubMed. The 787 initially retrieved articles were reviewed for further evaluation according to the inclusion/exclusion criteria (Prospero registration number CRD42021252682).

Results
Sixty-one articles were included in the review. The stress monitoring methods found in the articles showed heart rate analysis as the most used monitoring tool for physiological parameters while the STAI-6 scale was preferred for psychological parameters. The stress management methods found in the articles were mental-, simulation- and feedback-based training, with the mental-based training showing clear positive effects on participants. The studies analyzing the effects of stress on surgical performance showed both negative and positive effects on technical and non-technical performance.

Conclusions
The impact of stress responses presents an important factor in surgical environments, affecting residents’ training and performance. This study identified the main methods used for monitoring stress parameters in surgical educational environments. The applied surgical stress management training methods were diverse and demonstrated positive effects on surgeons’ stress levels and performance. There were negative and positive effects of stress on surgical performance, although a collective pattern on their effects was not clear.
Status and related factors of burnout among palliative nurses in China: a cross-sectional study
Authors: Zhang Yalin , Jiang Jianjun , Zhu Chuanmei , Liu Chunhua , Guan Chang , Hu Xiaolin 
Published: November 2022

Abstract
Background
Burnout occurs frequently in nurses and seems more common in nurses providing palliative care. However, to our knowledge, there is a lack of understanding regarding the factors influencing burnout among palliative nurses in China.

Methods
A cross-sectional design was conducted. A total of 331 palliative nurses from 25 hospitals participated in this study. Anonymous data were collected through a self-designed social-demographic questionnaire, the Nursing Burnout Scale, the Perceived Social Support Scale, the General Self-Efficacy Scale, the Connor-Davidson Resilience Scale, and the Simplified Coping Style Questionnaire. Independent sample t tests, one-way ANOVA, Pearson correlations, and multiple linear regressions were performed to identify the related factors of the three dimensions of burnout.

Results
In the results of multiple linear regression, resilience, health condition, coping style, and pessimistic personality were common related factors; in addition, end-of-life care training, social support, and income satisfaction were statistically significantly associated with burnout. These factors could explain 38.6%, 27.8%, and 34.5% of the total variance in emotional exhaustion, depersonalization, and reduced personal accomplishment, respectively.

Conclusions
The findings of this study help policy makers and nurse managers better understand burnout among palliative nurses in China. The results highlighted the importance of implementing culture-oriented training programs, providing perceived organizational support, and building a reasonable salary system to decrease burnout among palliative nurses, increase the quality of nursing and promote the development of Chinese palliative care.
Adherence of critical care nurses to endotracheal suctioning guidelines: a cross-sectional study
Authors: Alkubati Sameer A. , Al-Sayaghi Khaled M. , Alrubaiee Gamil G. , Hamid Mokhtar Abdu , Saleh Khalil A , Al-Qalah Talal , Al-Sadi Ahmad K. 
Published: November 2022

Abstract
Background
Endotracheal suctioning (ETS) is one of the most common invasive procedures performed by critical care nurses (CCNs) to remove accumulated pulmonary secretions, ensure airway patency for adequate ventilation and oxygenation as well as prevent atelectasis in intubated patients.

Objectives
To assess the practice of CCNs in intensive care units (ICUs) before, during, and after performing the ETS procedure and identify factors affecting their practice.

Methods
A cross-sectional and non-participant observational design was conducted in the ICUs of four hospitals in Hodeida city, Yemen. The data were collected using a 25-item observational checklist in the period from May to August 2019.

Results
More than half (55%) of CCNs scored undesirable (< 50%) regarding their adherence to ETS practice guidelines while the rest scored moderate (50–75%), with none of showing desirable adherence (> 70%) to the guidelines. There was no significant association between gender, age, education level, or length of experience of CCNs in the ICUs and their practice during performance ETS procedures. However, training (p = 0.010) and receiving information about ETS (p = 0.028) significantly improved the CCNs’ practice.

Conclusion
Most CCNs at the ICUs of Hodeida hospitals do not adhere to evidence-based practice guidelines when performing ETS procedures, possibly resulting in numerous adverse effects and complications for patients. CCNs receiving information and training show better ETS practice than do their counterparts. Therefore, it is necessary to provide the nursing staff with clear guidelines, continuous education and monitoring to improve their practices.
Association between gut microbiota and preeclampsia-eclampsia: a two-sample Mendelian randomization study
Authors: Li Pengsheng , Wang Haiyan , Guo Lan , Gou Xiaoyan , Chen Gengdong , Lin Dongxin , Fan Dazhi , Guo Xiaoling , Liu Zhengping 
Published: November 2022

Abstract
Background
Several recent observational studies have reported that gut microbiota composition is associated with preeclampsia. However, the causal effect of gut microbiota on preeclampsia-eclampsia is unknown.

Methods
A two-sample Mendelian randomization study was performed using the summary statistics of gut microbiota from the largest available genome-wide association study meta-analysis (n=13,266) conducted by the MiBioGen consortium. The summary statistics of preeclampsia-eclampsia were obtained from the FinnGen consortium R7 release data (5731 cases and 160,670 controls). Inverse variance weighted, maximum likelihood, MR-Egger, weighted median, weighted model, MR-PRESSO, and cML-MA were used to examine the causal association between gut microbiota and preeclampsia-eclampsia. Reverse Mendelian randomization analysis was performed on the bacteria that were found to be causally associated with preeclampsia-eclampsia in forward Mendelian randomization analysis. Cochran’s Q statistics were used to quantify the heterogeneity of instrumental variables.

Results
Inverse variance weighted estimates suggested that Bifidobacterium had a protective effect on preeclampsia-eclampsia (odds ratio = 0.76, 95% confidence interval: 0.64–0.89, P = 8.03 × 10−4). In addition, Collinsella (odds ratio = 0.77, 95% confidence interval: 0.60–0.98, P = 0.03), Enterorhabdus (odds ratio = 0.76, 95% confidence interval: 0.62–0.93, P = 8.76 × 10−3), Eubacterium (ventriosum group) (odds ratio = 0.76, 95% confidence interval: 0.63–0.91, P = 2.43 × 10−3), Lachnospiraceae (NK4A136 group) (odds ratio = 0.77, 95% confidence interval: 0.65–0.92, P = 3.77 × 10−3), and Tyzzerella 3 (odds ratio = 0.85, 95% confidence interval: 0.74–0.97, P = 0.01) presented a suggestive association with preeclampsia-eclampsia. According to the results of reverse MR analysis, no significant causal effect of preeclampsia-eclampsia was found on gut microbiota. No significant heterogeneity of instrumental variables or horizontal pleiotropy was found.

Conclusions
This two-sample Mendelian randomization study found that Bifidobacterium was causally associated with preeclampsia-eclampsia. Further randomized controlled trials are needed to clarify the protective effect of probiotics on preeclampsia-eclampsia and their specific protective mechanisms.
Comparison of the effects of triglyceride variability and exposure estimate on clinical prognosis in diabetic patients
Authors: Koh Sung Min , Chung Se Hwa , Yum Yun Jin , Park Se Jun , Joo Hyung Joon , Kim Yong-Hyun , Kim Eung Ju 
Published: November 2022

Abstract
Background
Hypertriglyceridemia is an important feature of dyslipidemia in type 1 and type 2 diabetic patients and associated with the development of atherosclerotic cardiovascular disease. Recently, variability of lipid profile has been suggested as a residual risk factor for cardiovascular disease. This study compared the clinical impact of serum triglyceride variability, and their cumulative exposure estimates on cardiovascular prognosis in diabetic patients.

Methods
A total of 25,933 diabetic patients who had serum triglyceride levels measured at least 3 times and did not have underlying malignancy, myocardial infarction (MI), and stroke during the initial 3 years (modeling phase) were selected from three tertiary hospitals. They were divided into a high/low group depending on their coefficient of variation (CV) and cumulative exposure estimate (CEE). Incidence of major adverse event (MAE), a composite of all-cause death, MI, and stroke during the following 5 years were compared between groups by multivariable analysis after propensity score matching.

Results
Although there was a slight difference, both the high CV group and the high CEE group had a higher cardiovascular risk profile including male-dominance, smoking, alcohol, dyslipidemia, and chronic kidney disease compared to the low groups. After the propensity score matching, the high CV group showed higher MAE incidence compared to the low CV group (9.1% vs 7.7%, p = 0.01). In contrast, there was no significant difference of MAE incidence between the high CEE group and the low CEE group (8.6% vs 9.1%, p = 0.44). After the multivariable analysis with further adjustment for potential residual confounding factors, the high CV was suggested as an independent risk predictor for MAE (HR 1.19 [95% CI 1.03–1.37]).

Conclusion
Visit-to-visit variability of triglyceride rather than their cumulative exposure is more strongly related to the incidence of MAE in diabetic patients.