bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hearing Loss and Dementia: A Meta-Analysis of Prospective Cohort Studies
Authors: Liang Zheng , Li Ao , Xu Yuanyuan , Qian Xiaoyun , Gao Xia 
Published: July 2021

Background: Consensus is lacking with regard to whether hearing loss is an independent risk factor for dementia. We therefore conducted a meta-analysis to clarify the relationship of hearing loss and dementia.Methods: Prospective cohort studies investigating the association between hearing loss and the incidence of dementia in a community-derived population were included by searching electronic databases that included PubMed, Embase, and Cochrane's Library. A random-effects model was adopted to combine the results.Results: Fourteen cohorts including 726,900 participants were analyzed. It was shown that hearing loss was independently associated with dementia [adjusted hazard ratio (HR): 1.59, 95% confidence interval (CI): 1.37 to 1.86, p &lt; 0.001; I2 = 86%]. Sensitivity analysis sequentially excluding any of the individual studies included showed similar results. Subgroup analysis according to the diagnostic methods for hearing loss, validation strategy for dementia, follow-up duration, and adjustment of apolipoprotein E genotype also showed consistent results (p-values for subgroup differences all &gt; 0.05). Meta-analysis with five studies showed that hearing loss was also connected to higher risk of Alzheimer's disease (adjusted HR: 2.24, 95% CI: 1.32 to 3.79, p = 0.003; I2 = 2%).Conclusions: Hearing loss may increase the risk of dementia in the adult population. Whether effective treatment for hearing loss could reduce the incidence of dementia should be explored in the future.
Transient Global Amnesia (TGA): Influence of Acute Hypertension in Patients Not Adapted to Chronic Hypertension
Authors: Rogalewski Andreas , Beyer Anne , Friedrich Anja , Plümer Jorge , Zuhorn Frédéric , Greeve Isabell , Klingebiel Randolf , Woermann Friedrich G. , Bien Christian G. , Schäbitz Wolf-Rüdiger 
Published: July 2021

Objective: Transient global amnesia (TGA) is defined by an acute memory disturbance of unclear etiology for a period of &lt;24 h. Several studies showed differences in vascular risk factors between TGA compared to transient ischemic attack (TIA) or healthy controls with varying results. This retrospective and cross-sectional study compares the cardiovascular risk profile of TGA patients with that of acute stroke patients.Methods: Cardiovascular risk profile and MR imaging of 277 TGA patients was retrospectively analyzed and compared to 216 acute ischemic stroke patients (26% TIA).Results: TGA patients were significantly younger and predominantly female compared to stroke patients. A total of 90.6% of TGA patients underwent MRI, and 53% of those showed hippocampal diffusion-weighted imaging (DWI) lesions. Scores for cerebral microangiopathy were lower in TGA patients compared to stroke patients. After statistical correction for age, TGA patients had higher systolic and diastolic blood pressure, higher cholesterol levels, lower HbA1c, as well as blood glucose levels, and lower CHA2DS2-VASc scores. Stroke patients initially displayed higher CRP levels than TIA and TGA patients. TGA patients without DWI lesions were older and showed higher CHA2DS2-VASc scores compared to TGA patients with DWI lesions.Conclusion: This study revealed significant differences between TGA and stroke patients in regard to the cardiovascular risk profile. Our main findings show a strong association between acute hypertensive peaks and TGA in patients not adapted to chronic hypertension, indicating a vascular cause of the disease.
Association of Red Meat and Poultry Consumption With the Risk of Metabolic Syndrome: A Meta-Analysis of Prospective Cohort Studies
Authors: Guo Hongbin , Ding Jun , Liang Jieyu , Zhang Yi 
Published: July 2021

Objective: This study aims to investigate the association of red meat (processed and unprocessed) and poultry consumption with the risk of metabolic syndrome (MetS).Methods: Prospective cohort studies on the association of red meat (processed and unprocessed) and poultry consumption with the risk of MetS were identified by comprehensive literature search in the PubMed, Web of Science, and Embase databases up to March 2021. The pooled relative risk (RR) of MetS with 95% CIs for the highest vs. lowest category of red meat or poultry consumption was extracted for meta-analysis.Results: A total of nine prospective cohort studies were included in this study. Among them, eight studies were identified for red meat consumption. The overall multi-variable adjusted RR demonstrated that red meat consumption was associated with a higher risk of MetS (RR = 1.35, 95% CI: 1.13–1.62; P = 0.001). Moreover, four and three studies were specifically related to processed and unprocessed red meat consumption, respectively. Both processed (RR = 1.48, 95% CI: 1.11–1.97; P = 0.007) and unprocessed red meat (RR = 1.32, 95% CI: 1.14–1.54; P = 0.0003) consumption was associated with a higher risk of MetS. With regard to poultry consumption, three studies were included. The overall multi-variable adjusted RR suggested that poultry consumption was associated with lower risk of MetS (RR = 0.85, 95% CI: 0.75–0.97; P = 0.02).Conclusions: The current evidence indicates that red meat (processed and unprocessed) consumption is associated with a higher risk of MetS, whereas, poultry consumption is associated with a lower risk of MetS. More well-designed randomized controlled trials are still needed to address the issues further.
Exploratory Analysis to Predict Optimal Tumor Burden for Starting Lenvatinib in Patients With Radioiodine-Refractory Differentiated Thyroid Cancer
Authors: Suzuki Chiaki , Kiyota Naomi , Imamura Yoshinori , Goto Hideaki , Suto Hirotaka , Chayahara Naoko , Toyoda Masanori , Ito Yasuhiro , Miya Akihiro , Miyauchi Akira , Teshima Masanori , Otsuki Naoki , Nibu Ken-ichi , Minami Hironobu 
Published: July 2021

BackgroundWe previously reported that a high tumor burden is a prognostic factor based on an analysis of 26 patients with radioactive iodine-refractory differentiated thyroid cancer (RR-DTC) who were treated with lenvatinib. However, the optimal tumor burden for starting lenvatinib still remains to be defined. The aim of this retrospective study was to further explore in the same patient cohort the optimal timing for the start of lenvatinib by focusing on the pre- and post-treatment tumor burden.MethodsThe 26 patients were treated with lenvatinib from 2012 to 2017. We explored the optimal timing for the start of lenvatinib by comparing the characteristics of long-term responders who were defined as patients with progression-free survival ≥ 30 months and non-long-term responders.ResultsLong-term responders had a smaller post-treatment tumor burden at maximum shrinkage than non-long-term responders. Further, post-treatment tumor burden had a strong linear correlation with baseline tumor burden. We created an estimation formula for baseline tumor burden related to prognosis, using these regression lines. Patients with a sum of diameters of target lesions &lt; 60 mm or maximum tumor diameter &lt; 34 mm at baseline were estimated to have significantly better survival outcomes.ConclusionsWe found a strong linear correlation between pre- and post-treatment tumor burden. Our results suggested a cut-off value for baseline tumor burden for long-term prognosis among patients treated with lenvatinib.
Diagnostic Value of CircRNAs as Potential Biomarkers in Oral Squamous Cell Carcinoma: a Meta-Analysis
Authors: Wang Mingfei , Zhang Linfeng , Ren Wenhao , Li Shaoming , Zhi Keqian , Zheng Jingjing , Gao Ling 
Published: July 2021

IntroductionCircular RNAs (CircRNAs), an emerging non-coding RNA, have been demonstrated to be involved in tumorigenesis, metastasis, and cancer progression, and could represent novel potential biomarkers for diagnosing oral squamous cell carcinoma (OSCC). However, no meta-analysis has investigated the diagnostic role of circRNAs in OSCC. Hence, to investigate whether circRNAs could serve as specific biomarkers for OSCC, the present systematic review and meta-analysis evaluated the diagnostic efficiency of circRNAs in patients with OSCC.Materials and MethodsA thorough search of online databases (Pubmed, Web of Science, Embase, and the Cochrane Library) was conducted to collect relevant studies up to March 30th, 2021. All eligible studies were case-control studies. The quality of each study was evaluated by the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. STATA (version 15.1) and Review Manager (version 5.4) were employed to conduct the meta-analysis, and the PRISMA statement was adopted in this study.ResultsA total of 16 studies were included in the meta-analysis, with five studies on upregulated circRNAs, and 11 on downregulated circRNAs. The enrolled studies that met our eligibility criteria all derived from China. The pooled sensitivity (SEN), specificity (SPE), diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and the area under receiver operating characteristics curve (AUC) with the 95% confidence intervals (95% CIs) were 0.74 (0.69–0.79), 0.79 (0.73–0.84), 10.74 (7.81–14.77), 3.50 (2.78–4.45), 0.33 (0.27–0.39) and 0.83 (0.79–0.86), respectively. The subgroup analysis demonstrated that serum, plasma, and saliva specimens had a better diagnostic performance than tissue samples, with a high value of sensitivity, specificity, DOR, and AUC values. The results also showed that the subgroups of upregulated circRNAs and a sample size of ≥100 manifested higher specificity, DOR, and AUC for cancer detection than downregulated circRNAs and a sample size of &lt; 100.ConclusionsA strong association was demonstrated between the dysregulated expression of circRNAs and the diagnosis of OSCC. Hence, circRNAs have the potential to function as promising biomarkers and therapeutic targets for OSCC.Systematic Review RegistrationPROSPERO, number CRD42021256857.
Predictive Value of HE4 in Platinum-Based Chemotherapy for Ovarian Cancer: A Systematic Review
Authors: Han Yue , Jiang Lili , Liu Kuiran , Ouyang Ling , Li Yan 
Published: July 2021

ObjectiveTo evaluate the value of serum Human epididymis protein 4 (HE4) for predicting the resistance of ovarian cancer (OS) to platinum chemotherapy.MethodWe searched the MEDLINE (PubMed), EMBASE, Cochrane Central, Web of Science, SCOPUS, and CNKI databases and screened all studies evaluating serum HE4 for predicting OC resistance to treatment with platinum. Two researchers independently evaluated the quality of all eligible original studies using QUADAS-2. RevMan 5.4 was used to compile the quality evaluation form. We also performed a meta-analysis with STATA15.1, and Deek’s funnel plots were used to detect any publication bias.ResultsEight studies were included in the final meta-analysis. Our results showed that the sensitivity and specificity of preoperative serum HE4 in predicting the resistance of OC to platinum chemotherapy was 80% and 67%, respectively. The diagnostic odds ratio was 8, and the AUC was 0.78 (95% CI: 0.75-0.82), whereas the pooled sensitivity and specificity of serum HE4 after the third-cycle of chemotherapies for predicting chemoresistance in OC was 86% and 85%, respectively, with a diagnostic odds ratio of 33 and AUC = 0.92 (95% CI: 0.89 – 0.94).ConclusionHE4 may be an effective predictor of platinum-based chemotherapeutic resistance of OC. Serum HE4 levels after the third chemotherapy cycle may be indicative for clinical practice. Further research is needed to validate the significance of HE4 in the long-term management of OC.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, PROSPERO (CRD42021220099).
Self-Reported Health in Adolescents With Exercise-Induced Laryngeal Obstruction; A Cross-Sectional Study
Authors: Benestad Merete R. , Drageset Jorunn , Clemm Hege , Røksund Ola D. , Vollsæter Maria , Halvorsen Thomas , Hysing Mari , Vederhus Bente J. 
Published: July 2021

Background: Exercise-induced laryngeal obstruction (EILO) is common in young people with exertional breathing difficulties. Psychological characteristics have been proposed as underlying contributors; however, the evidence for this is limited.Objectives: Describe self-reported health, self-efficacy, and anxiety symptoms in adolescents with EILO, and address possible associations with EILO subtypes and severity.Methods: Cross-sectional study of 71/180 (39%) adolescents tested for EILO at Haukeland University Hospital during 2014–2016, age range 14–18 years. Validated questionnaires were used to assess general self-rated health, subjective health complaints (Health Behavior in School-aged Children-Symptom Check List; HBSC-SCL), general self-efficacy (GSE), and anxiety symptoms (SCARED). The outcomes were compared with normative data from comparable unselected populations.Results: The HBSC-SCL items for somatic complaints revealed weekly or more often occurrence of headache in 42%, abdominal pain in 30%, backache in 31%, and dizziness in 32%. For psychological complaints, corresponding figures were 26% for feeling low, 43% for irritability or bad mood, 33% for feeling nervous, and 38% for sleep problems. Mean (range) GSE score was 3.13 (2.2–4.0), and reports suggesting anxiety symptoms were rare. The outcomes were in line with normative data from comparable unselected populations. Self-rated health, and scores obtained for HBSC-SCL, GSE, and SCARED were similarly distributed across EILO subtypes and severity.Conclusion: Self-reported health, self-efficacy, and level of anxiety symptoms in adolescents with laryngoscopically confirmed EILO were similar to data obtained in comparable unselected populations, irrespective of EILO subtype and severity. The findings challenge the notion that pediatric EILO is causally related to psychological problems.
The Computerized Adaptable Test Battery (BMT-i) for Rapid Assessment of Children's Academic Skills and Cognitive Functions: A Validation Study
Authors: Billard Catherine , Thiébaut Eric , Gassama Sahawanatou , Touzin Monique , Thalabard Jean-Christophe , Mirassou Anne , Munnich Arnold 
Published: July 2021

Background: Learning disabilities in children are a major public health concern worldwide, having a prevalence of 8%. They are associated with lost social, educational, and ultimately, professional opportunities for individuals. These disabilities are also very costly to governments and raise the issue of the appropriate means of screening. Unfortunately, validated tools for preliminary appraisal of learning and cognitive function in struggling children are presently restricted to specific age ranges and cognitive domains. This study sought to validate a first-line battery for assessment of academic skills and cognitive functions.Materials and Methods: The computerized Adaptable Test Battery, or BMT-i, includes a panel of tests for the first-line assessment of children's academic skills and cognitive functions. The tests reflect expected abilities for the age group in question, exploring academic skills (written language and mathematical cognition) and cognitive domains (verbal, non-verbal, and attentional/executive functions). The authors relied on the results of these tests for a sample of 1,074 Francophone children representative of the mainland French school-age population (522 boys and 552 girls, ages 4–13, from 39 classes at 7 public and 5 private schools). Thirteen speech-language pathologists and neuropsychologists individually administered the tests.Results: The psychometric characteristics of the empirical data obtained showed acceptable to good test homogeneity, internal consistency (Cronbach's alpha: &gt; 0.70), test-retest reliability (intraclass correlation coefficients: ~0.80), and consistency with reference test batteries (r: 0.44–0.96).Conclusion: The BMT-i was validated in a large sample of children in mainstream French schools, paving the way for its use in first-line screening of learning disabilities among children with complaints, whether their learning difficulties have been flagged by their parents or by their teachers.
Relationship Between Medication Literacy and Frailty in Elderly Inpatients With Coronary Heart Disease: A Cross-Sectional Study in China
Authors: Qu Jiling , Zhou Ting , Xue Mengxin , Sun Huiping , Shen Yijing , Liu Yongbing 
Published: July 2021

Background: Mastering medication literacy may be related to medication safety, and the identification of frailty is very important for the prognosis of coronary heart disease (CHD). Few studies have examined the relationship between medication literacy and frailty in patients with CHD. The aim of this study was to investigate the state of medication literacy and frailty in patients with CHD and to explore the relationship between medication literacy and frailty.Methods: A cross-sectional investigation evaluated 295 inpatients with CHD recruited from hospitals in Yangzhou, China. Demographic and clinical data on participants were collected using a general information questionnaire. The Chinese medication literacy scale was used to evaluate medication literacy. The Fried Frailty Phenotype scale was used to evaluate frailty. Univariate analysis employed chi-square test and Kruskal-Wallis H test to examine the potential factors affecting frailty. Taking frailty status as the outcome variable, the ordered logistic regression model was used to analyze the relationship between the degree of medication literacy and frailty. Spearman’s correlation analysis was used to analyze the correlation between medication literacy and frailty.Results: A total of 280 elderly CHD inpatients were included in the analysis. There were 116 (41.4%) individuals with inadequate medication literacy and 89 (31.8%) frail individuals. Ordered logistic regression analysis showed that the age (p &lt; 0.001, OR = 1.089), Charson Comorbidity Index (p = 0.029, OR = 1.300), number of medications taken (p = 0.012, OR = 1.137), and medication literacy (p &lt; 0.05, OR &gt; 1) were independent predictors of debilitating risk factors. The population with inadequate medication literacy had a 2.759 times greater risk of frailty than adequate medication literacy (p &lt; 0.001, OR = 2.759); The population with marginal medication literacy had a 2.239 times greater risk of frailty than adequate medication literacy (p = 0.010, OR = 2.239). Spearman’s correlation analysis showed that the medication literacy grade was associated with the frailty grade in elderly CHD patients (R = -0.260, p &lt; 0.001).Conclusion: The study showed a significant correlation between medical literacy and frailty in patients with CHD. The results suggested that medication literacy was an important consideration in the development, implementation, and evaluation of frailty.
A Qualitative Endline Evaluation Study of Male Engagement in Promoting Reproductive, Maternal, Newborn, and Child Health Services in Rural Kenya
Authors: Lusambili Adelaide M. , Wisofschi Stefania , Shumba Constance , Muriuki Peter , Obure Jerim , Mantel Michaela , Mossman Lindsay , Pell Rachel , Nyaga Lucy , Ngugi Anthony , Orwa James , Luchters Stanley , Mulama Kennedy , Wade Terrance J. , Temmerman Marleen 
Published: July 2021

Background: Globally, male involvement in reproductive, maternal, newborn, and child health (RMNCH) is associated with increased benefits for women, their children, and their communities. Between 2016 and 2020, the Aga Khan University implemented the Access to Quality of Care through Extending and Strengthening Health Systems (AQCESS), project funded by the Government of Canada and Aga Khan Foundation Canada (AKFC). A key component of the project was to encourage greater male engagement in RMNCH in rural Kisii and Kilifi, two predominantly patriarchal communities in Kenya, through a wide range of interventions. Toward the end of the project, we conducted a qualitative evaluation to explore how male engagement strategies influenced access to and utilization of RMNCH services. This paper presents the endline evaluative study findings on how male engagement influenced RMNCH in rural Kisii and Kilifi.Methods: The study used complementing qualitative methods in the AQCESS intervention areas. We conducted 10 focus group discussions (FGDs) with 82 community members across four groups including adult women, adult men, adolescent girls, and adolescent boys. We also conducted 11 key informant interviews (KIIs) with facility health managers, and sub-county and county officials who were aware of the AQCESS project.Results: Male engagement activities in Kisii and Kilifi counties were linked to improved knowledge and uptake of family planning (FP), spousal/partner accompaniment to facility care, and defeminization of social and gender roles.Conclusion: This study supports the importance of male involvement in RMNCH in facilitating decisions on women and children's health as well as in improving spousal support for use of FP methods.
Diagnostic Accuracy of Machine Learning Models to Identify Congenital Heart Disease: A Meta-Analysis
Authors: Hoodbhoy Zahra , Jiwani Uswa , Sattar Saima , Salam Rehana , Hasan Babar , Das Jai K. 
Published: July 2021

Background: With the dearth of trained care providers to diagnose congenital heart disease (CHD) and a surge in machine learning (ML) models, this review aims to estimate the diagnostic accuracy of such models for detecting CHD.Methods: A comprehensive literature search in the PubMed, CINAHL, Wiley Cochrane Library, and Web of Science databases was performed. Studies that reported the diagnostic ability of ML for the detection of CHD compared to the reference standard were included. Risk of bias assessment was performed using Quality Assessment for Diagnostic Accuracy Studies-2 tool. The sensitivity and specificity results from the studies were used to generate the hierarchical Summary ROC (HSROC) curve.Results: We included 16 studies (1217 participants) that used ML algorithm to diagnose CHD. Neural networks were used in seven studies with overall sensitivity of 90.9% (95% CI 85.2–94.5%) and specificity was 92.7% (95% CI 86.4–96.2%). Other ML models included ensemble methods, deep learning and clustering techniques but did not have sufficient number of studies for a meta-analysis. Majority (n=11, 69%) of studies had a high risk of patient selection bias, unclear bias on index test (n=9, 56%) and flow and timing (n=12, 75%) while low risk of bias was reported for the reference standard (n=10, 62%).Conclusion: ML models such as neural networks have the potential to diagnose CHD accurately without the need for trained personnel. The heterogeneity of the diagnostic modalities used to train these models and the heterogeneity of the CHD diagnoses included between the studies is a major limitation.