bluuebunny/crossref_metadata_2025_split huggingface dataset:
FGF-23 correlates with endocrine and metabolism dysregulation, worse cardiac and renal function, inflammation level, stenosis degree, and independently predicts in-stent restenosis risk in coronary heart disease patients underwent drug-eluting-stent PCI
Authors: Song Tingting , Fu Yang , Wang Yanbo , Li Wei , Zhao Jiayu , Wang Xun , Wang Haiyan , Zhao Ying , Fu Xianghua 
Published: January 2021

AbstractBackgroundThe present study aimed to assess the correlation of fibroblast growth factor (FGF)-23 expression with clinical characteristics, then further explore its value in predicting 2-year in-stent restenosis (ISR) risk in coronary heart disease (CHD) patients underwent percutaneous coronary intervention (PCI) with drug-eluting stent (DES).MethodsIn this prospective, single-center, observational study, totally 214 CHD patients treated by PCI with DES were consecutively recruited, and peripheral blood samples were collected prior to PCI with DES for serum samples isolation. Following, FGF-23 level in the serum samples was detected via enzyme linked-immuno-sorbent Assay. The follow-up coronary angiography was performed at 1 year and 2 years after PCI or if suspected ISR symptoms occurred.ResultsFGF-23 was positively correlated with fasting blood-glucose, insulin resistance, serum creatinine, serum uric acid, LDL-C, high-sensitivity C-reactive protein, cardiac troponin I and N-terminal-proB-type natriuretic peptide, while was negatively associated with HDL-C and left ventricular ejection fraction (allP < 0.01). Furthermore, FGF-23 was positively correlated with hypercholesteremia, hyperuricemia and family history of CAD (allP < 0.05). However, it did not correlate with other chronic complications, biochemical indexes, lesion features or PCI parameters (allP > 0.05). Moreover, FGF-23 level was higher in 2-year ISR patients (n = 38) compared to 2-year non-ISR patients (n = 176) (P < 0.001), and receiver operating characteristic curve indicated that FGF-23 was of good value in predicting 2-year ISR risk (AUC 0.828, 95% CI 0.761–0.896).ConclusionFGF-23 correlates with endocrine and metabolism dysregulation, worse cardiac and renal function, inflammation level, stenosis degree of target lesion, and serves as an independent risk factor for 2-year ISR risk in CHD patients underwent PCI with DES.
Incorporating and addressing testing bias within estimates of epidemic dynamics for SARS-CoV-2
Authors: Suhail Yasir , Afzal Junaid , Kshitiz  
Published: January 2021

AbstractBackgroundThe disease burden of SARS-CoV-2 as measured by tests from various localities, and at different time points present varying estimates of infection and fatality rates. Models based on these acquired data may suffer from systematic errors and large estimation variances due to the biases associated with testing. An unbiased randomized testing to estimate the true fatality rate is still missing.MethodsHere, we characterize the effect of incidental sampling bias in the estimation of epidemic dynamics. Towards this, we explicitly modeled for sampling bias in an augmented compartment model to predict epidemic dynamics. We further calculate the bias from differences in disease prediction from biased, and randomized sampling, proposing a strategy to obtain unbiased estimates.ResultsOur simulations demonstrate that sampling biases in favor of patients with higher disease manifestation could significantly affect direct estimates of infection and fatality rates calculated from the numbers of confirmed cases and deaths, and serological testing can partially mitigate these biased estimates.ConclusionsThe augmented compartmental model allows the explicit modeling of different testing policies and their effects on disease estimates. Our calculations for the dependence of expected confidence on a randomized sample sizes, show that relatively small sample sizes can provide statistically significant estimates for SARS-CoV-2 related death rates.
Parents’ concerns and beliefs about temperature measurement in children: a qualitative study
Authors: Morris Elizabeth , Glogowska Margaret , Ismail Fatene Abakar , Edwards George , Fleming Susannah , Wang Kay , Verbakel Jan Y. , Van den Bruel Ann , Hayward Gail 
Published: January 2021

Abstract
Background
Nearly 40% of parents with children aged 6 to 17 months consult a healthcare professional when their child has a high temperature. Clinical guidelines recommend temperature measurement in these children, but little is known about parents’ experiences of and beliefs about temperature measurement. This study aimed to explore parents’ concerns and beliefs about temperature measurement in children.

Methods
Semi-structured qualitative interviews were conducted from May 2017 to June 2018 with 21 parents of children aged 4 months to 5.5 years, who were purposively sampled from the METRIC study (a method comparison study comparing non-contact infrared thermometers to axillary and tympanic thermometers in acutely ill children). Data analysis followed a thematic approach.

Results
Parents described the importance of being able to detect fever, in particular high fevers, and how this then influenced their actions. The concept of “accuracy” was valued by parents but the aspects of performance which were felt to reflect accuracy varied. Parents used numerical values of temperature in four main ways: determining precision of the thermometer on repeat measures, detecting a “bad” fever, as an indication to administer antipyretics, or monitoring response to treatment. Family and social networks, the internet, and medical professionals and resources, were all key sources of advice for parents regarding fever, and guiding thermometer choice.

Conclusions
Temperature measurement in children has diagnostic value but can either empower, or cause anxiety and practical challenges for parents. This represents an opportunity for both improved communication between parents and healthcare professionals, and technological development, to support parents to manage febrile illness with greater confidence in the home.
Utility of a 21-gauge Menghini-type biopsy needle with the rolling method for an endoscopic ultrasound-guided histological diagnosis of autoimmune pancreatitis: a retrospective study
Authors: Tsutsumi Koichiro , Ueki Toru , Noma Yasuhiro , Omonishi Kunihiro , Ohno Kyotaro , Kawahara Soichiro , Oda Takashi , Kato Hironari , Okada Hiroyuki 
Published: January 2021

Abstract
Background
The histological diagnosis of autoimmune pancreatitis (AIP) by an endoscopic ultrasound (EUS)-guided approach is still challenging.

Methods
We investigated the utility of the 21-gauge Menghini-type biopsy needle with the rolling method for the histological diagnosis of AIP, in comparison with conventional 22-gauge needles. Among total 28 patients, rate of definitive histological diagnosis, acquired sample area of tissue, rate of histopathological diagnosis of AIP, and adverse events were retrospectively analyzed.

Results
Definitive histological diagnoses were successfully accomplished in all 14 patients (100%) treated with a Menghini-type needle, and in 57% of cases (8/14) treated with conventional 22-gauge needles (P < 0.001). The median sample area of the tissue, except for blood contamination, was remarkably larger by the Menghini-type needle than by conventional-type needles (6.2 [IQR, 4.5–8.8] versus 0.7 [IQR, 0.2–2.0] mm2, P < 0.001), and the area per punctures was approximately 4 times larger (1.4 [IQR: 0.9–2.9] versus 0.3 [IQR: 0.1–0.6] mm2/puncture, P < 0.001). Based on the International Consensus Diagnostic Criteria, lymphoplasmacytic infiltration, abundant IgG4-postive cells, storiform fibrosis, and obliterative phlebitis were found in 86%/29%, 64%/0%, 36%/0%, and 7%/0% patients who were treated with the Menghini-type needle and conventional-type needles, respectively. Consequently, histopathological diagnosis with type 1 AIP (lever 1 or 2) was achieved in 9 patients (64%) treated with the Menghini-type needle and in no patient treated with conventional-type needles (P < 0.001). Two patients who had mild post-procedural pancreatitis improved with conservative treatment, and no bleeding occurred in patients treated with the Menghini-type needle.

Conclusion
EUS-guided rolling method with the 21-gauge Menghini-type biopsy needle is useful for the histopathological diagnosis of AIP, due to its abundant acquisition of good-quality tissue from the pancreas.
The level and prevalence of depression and anxiety among patients with different subtypes of irritable bowel syndrome: a network meta-analysis
Authors: Hu Zhichao , Li Meixuan , Yao Liang , Wang Yinshu , Wang Enkang , Yuan Jianye , Wang Fengyun , Yang Kehu , Bian Zhaoxiang , Zhong Linda L. D. 
Published: January 2021

Abstract
Background
Irritable bowel syndrome (IBS) is a very common functional bowel disorder. However, the difference of depression and anxiety comorbidities among different IBS subtypes is still not well evaluated. This study aims to investigate the difference in the level and prevalence of depression and anxiety among healthy controls and patients with different subtypes of IBS.

Methods
PubMed, EMBASE and the Cochrane library were searched systematically until August 17, 2020. Studies that investigated depression and/or anxiety levels or prevalence among different IBS-subtype patients measured at baseline or the same point were included. Network meta-analysis was conducted to analyze standardized mean difference (SMD) of anxiety and depression levels, and single arm meta-analysis was performed for prevalence of anxiety and depression among different IBS subtypes.

Results
Eighteen studies involving 7095 participants were included. Network meta-analyses results showed healthy controls had a lower level of depression than IBS with mixed symptoms of constipation and diarrhea (IBS-M) [SMD =  − 1.57; 95% confidence interval (CI) − 2.21,  − 0.92], IBS with constipation (IBS-C) (SMD =  − 1.53; 95% CI − 2.13,  − 0.93) and IBS with diarrhea (IBS-D)(SMD =  − 1.41; 95% CI − 1.97,  − 0.85), while no significant difference was found between IBS unclassified (IBS-U) and healthy controls (SMD =  − 0.58; 95% CI  − 2.15, 1.00). There was also no significant difference in the level of depression among different IBS subtypes patients. The results of anxiety were similar to depression. Ranking probability showed that IBS-M was associated with the highest level of depression and anxiety symptoms, followed by IBS-C/IBS-D and IBS-U. Single-arm meta-analysis showed IBS-C had the highest prevalence of depression (38%) and anxiety (40%), followed by IBS-D, IBS-M and IBS-U.

Conclusion
The results indicated that IBS-M was more likely to be associated with a higher level of depression and anxiety, and the prevalence of depression and anxiety in IBS-C was highest. The psychological screening and appropriate psychotherapy are needed for patients with IBS-C, IBS-D and IBS-M instead of IBS-U.
General practitioners’ deprescribing decisions in older adults with polypharmacy: a case vignette study in 31 countries
Authors: Jungo Katharina Tabea , Mantelli Sophie , Rozsnyai Zsofia , Missiou Aristea , Kitanovska Biljana Gerasimovska , Weltermann Birgitta , Mallen Christian , Collins Claire , Bonfim Daiana , Kurpas Donata , Petrazzuoli Ferdinando , Dumitra Gindrovel , Thulesius Hans , Lingner Heidrun , Johansen Kasper Lorenz , Wallis Katharine , Hoffmann Kathryn , Peremans Lieve , Pilv Liina , Šter Marija Petek , Bleckwenn Markus , Sattler Martin , van der Ploeg Milly , Torzsa Péter , Kánská Petra Bomberová , Vinker Shlomo , Assenova Radost , Bravo Raquel Gomez , Viegas Rita P. A. , Tsopra Rosy , Pestic Sanda Kreitmayer , Gintere Sandra , Koskela Tuomas H. , Lazic Vanja , Tkachenko Victoria , Reeve Emily , Luymes Clare , Poortvliet Rosalinde K. E. , Rodondi Nicolas , Gussekloo Jacobijn , Streit Sven 
Published: January 2021

Abstract
Background
General practitioners (GPs) should regularly review patients’ medications and, if necessary, deprescribe, as inappropriate polypharmacy may harm patients’ health. However, deprescribing can be challenging for physicians. This study investigates GPs’ deprescribing decisions in 31 countries.

Methods
In this case vignette study, GPs were invited to participate in an online survey containing three clinical cases of oldest-old multimorbid patients with potentially inappropriate polypharmacy. Patients differed in terms of dependency in activities of daily living (ADL) and were presented with and without history of cardiovascular disease (CVD). For each case, we asked GPs if they would deprescribe in their usual practice. We calculated proportions of GPs who reported they would deprescribe and performed a multilevel logistic regression to examine the association between history of CVD and level of dependency on GPs’ deprescribing decisions.

Results
Of 3,175 invited GPs, 54% responded (N = 1,706). The mean age was 50 years and 60% of respondents were female. Despite differences across GP characteristics, such as age (with older GPs being more likely to take deprescribing decisions), and across countries, overall more than 80% of GPs reported they would deprescribe the dosage of at least one medication in oldest-old patients (> 80 years) with polypharmacy irrespective of history of CVD. The odds of deprescribing was higher in patients with a higher level of dependency in ADL (OR =1.5, 95%CI 1.25 to 1.80) and absence of CVD (OR =3.04, 95%CI 2.58 to 3.57).

Interpretation
The majority of GPs in this study were willing to deprescribe one or more medications in oldest-old multimorbid patients with polypharmacy. Willingness was higher in patients with increased dependency in ADL and lower in patients with CVD.
Falls efficacy instruments for community-dwelling older adults: a COSMIN-based systematic review
Authors: Soh Shawn Leng-Hsien , Lane Judith , Xu Tianma , Gleeson Nigel , Tan Chee Wee 
Published: January 2021

Abstract
Background
Falls efficacy is a widely-studied latent construct in community-dwelling older adults. Various self-reported instruments have been used to measure falls efficacy. In order to be informed of the choice of the best measurement instrument for a specific purpose, empirical evidence of the development and measurement properties of falls efficacy related instruments is needed.

Methods
The Consensus-based Standards for the Selection of Health Measurement Intruments (COSMIN) checklist was used to summarise evidence on the development, content validity, and structural validity of instruments measuring falls efficacy in community-dwelling older adults. Databases including MEDLINE, Web of Science, PsychINFO, SCOPUS, CINAHL were searched (May 2019). Records on the development of instruments and studies assessing content validity or structural validity of falls efficacy related scales were included. COSMIN methodology was used to guide the review of eligible studies and in the assessment of their methodological quality. Evidence of content validity: relevance, comprehensiveness and comprehensibility and unidimensionality for structural validity were synthesised. A modified GRADE approach was applied to evidence synthesis.

Results
Thirty-five studies, of which 18 instruments had been identified, were included in the review. High-quality evidence showed that the Modified Falls Efficacy Scale (FES)-13 items (MFES-13) has sufficient relevance, yet insufficient comprehensiveness for measuring falls efficacy. Moderate quality evidence supported that the FES-10 has sufficient relevance, and MFES-14 has sufficient comprehensibility. Activities-specific Balance Confidence (ABC) Scale–Simplified (ABC-15) has sufficient relevance in measuring balance confidence supported by moderate-quality evidence. Low to very low-quality evidence underpinned the content validity of other instruments. High-quality evidence supported sufficient unidimensionality for eight instruments (FES-10, MFES-14, ABC-6, ABC-15, ABC-16, Iconographical FES (Icon-FES), FES–International (FES-I) and Perceived Ability to Prevent and Manage Fall Risks (PAPMFR)).

Conclusion
Content validity of instruments to measure falls efficacy is understudied. Structural validity is sufficient for a number of widely-used instruments. Measuring balance confidence is a subset of falls efficacy. Further work is needed to investigate a broader construct for falls efficacy.
The association between medication or alcohol use and the incidence of frailty: a retrospective cohort study
Authors: Jazbar Janja , Locatelli Igor , Kos Mitja 
Published: January 2021

AbstractBackgroundUnderstanding potentially modifiable factors that influence the risk of frailty is a key concern for the management of this urgent contemporary public health challenge. This study evaluates the association between the use of various medications or alcohol and the incidence of frailty among older adults.MethodsThis study was a retrospective cohort study on older adults (≥ 65 years) using data from the longitudinal Survey of Health, Ageing and Retirement in Europe (SHARE survey, 28 countries). Medication use was measured as taking several different groups of medications. Alcohol use was assessed with SHARE questions corresponding to AUDIT-C. The outcome measure was the incidence of frailty after two years, defined by frailty index (FI) and frailty phenotype (FP). A multiple logistic regression model was used to evaluate the association with adjustment for several potential confounding factors.ResultsOf the 14,665 FI-population participants, 1800 (12.3%) developed frailty within two years. Of the 8133 FP-population participants, 2798 (34.4%) developed pre-frailty and 247 (3.0%) developed frailty within two years of baseline. After adjustment for potential confounding variables, non-hazardous alcohol use (adjusted OR; 95% CI for the FI-population: 0.68; 0.60–0.77) and hazardous alcohol use (0.80; 0.68–0.93) are associated with lower incidence of frailty compared to no alcohol use. The odds of frailty are increased when taking medications; the largest effect size was observed in older adults taking medication for chronic bronchitis (adjusted OR; 95% CI for the FI-population: 2.45; 1.87–3.22), joint pain and other pain medication (2.26; 2.00–2.54), medication for coronary and other heart disease (1.72; 1.52–1.96), medication for diabetes (1.69; 1.46–1.96), and medication for anxiety, depression and sleep problems (1.56; 1.33–1.84). Additionally, the risk of frailty was increased with stroke, Parkinson’s disease and dementia.ConclusionsTaking certain groups of medication was associated with increased incidence of frailty and pre-frailty, which might be due to either medication use or the underlying disease. Alcohol use was associated with a lower risk of pre-frailty and frailty compared to no alcohol use, which might be due to reverse causality or residual confounding. There was no significant interaction effect between medication groups and alcohol use on frailty incidence.
Health professionals perception and beliefs about drug- related problems on polymedicated older adults- a focus group study
Authors: Plácido Ana Isabel , Herdeiro Maria Teresa , Simões João Lindo , Amaral Odete , Figueiras Adolfo , Roque Fátima 
Published: January 2021

Abstract
Background
Polymedicated older patients are at greater risk of suffering from adverse events. For this reason, the detection of both inappropriate polypharmacy and polypharmacy-associated Drug-Related Problems (DRPs) are essential to improve the health and wellbeing of older adults and to reduce healthcare costs. This work aims to explore health professionals’ perceptions and opinions about polypharmacy and the handling of medicines by polymedicated older adults.

Methods
Thirteen focus groups with 94 health professionals (20 community pharmacists, 40 general practitioners and, 34 nurses) were conducted in primary healthcare centers of the center region of Portugal. Participants were asked to discuss their perceptions and beliefs concerning DRPs in polymedicated older adults. The sessions were audiotaped. After the transcription and coding of focus group sessions, a thematic analysis was done.

Results
The following four main themes emerged from the 13 focus group sessions: poor compliance and polypharmacy- A perpetuated vicious cycle, organization of the healthcare system, interaction and communication between the health professionals, and strategies to prevent inappropriate polypharmacy.

Conclusions
The lack of both an efficient network of information and Interaction and communication between Health professionals makes the detection and/ or prevention of polypharmacy in older adults difficult. The implementation of new models to manage and/or prevent polypharmacy based on health professional perception and beliefs is essential to prevent DRPs and improve compliance among older adults.
Association between social capital and loneliness among older adults: a cross-sectional study in Anhui Province, China
Authors: Bai Zhongliang , Wang Zijing , Shao Tiantai , Qin Xia , Hu Zhi 
Published: January 2021

AbstractBackgroundWe aimed to examine the association between social capital and loneliness in Anhui Province, China.MethodsData were collected from a cross-sectional study using a multi-stage stratified cluster sampling strategy. Data on demographic characteristics, socioeconomic factors, social capital, and loneliness in 1810 older adults (aged 60 years and older) were used for analysis. Binary logistic regression models and a classification and regression tree model were performed to assess the association of social capital and loneliness.ResultsOur results indicated that social capital in terms of lower level of social participation (AOR = 1.38; 95% CI: 1.10–1.74), social connection (AOR = 1.51; 95% CI: 1.18–1.93), and reciprocity (AOR = 1.47; 95% CI: 1.13–1.90) were associated with higher odds of developing loneliness. We noted the interactive effect of different social capital dimensions on loneliness, suggesting that the risk for suffering loneliness was greatest in older people limited in functional ability, with less trust, less social connection, and less social participation.ConclusionsOur findings show that social capital is associated with loneliness in older adults. This implies that social capital, especially in terms of trust, social connection, and social participation may be significant for alleviating loneliness in later life.
Psychometric properties of the Chinese version of the aging transformation scale for older adults with dementia
Authors: Li Lai You , Sun Ning , Yu Li Bo , Dong Xiao Xin , Ying Yu Chen , Lang Han Jun , Zhou Li Heng 
Published: January 2021

Abstract
Background
The key part of home care services is the assessment of the needs of the home environment for older adults with dementia. The present study was conducted to evaluate the psychometric properties of a newly adapted Chinese version of an instrument designed to measure aging transformation needs among older adults with dementia.

Methods
A sample of 175 older adults with dementia was selected from ten communities in China. The 55-item aging transformation needs scale was answered by the participants. Content validity, Cronbach’s alpha, item-to-total correlation, and exploratory factor analysis were used to assess the reliability and validity of the instrument.

Results
The aging transformation needs scale has a good surface validity, content validity, and structural validity. The content validity was 0.965; 55 items had large factor loads on their corresponding principal components (≥0.5). There was a significant correlation between the aging transformation needs scale and each component (r = 0.897–0.973, all P< 0.01), and 9 components also had a high correlation (r = 765~0.977, all P< 0.01); the total table Cronbach’s α was 0.993, the Cronbach’s α of each constituent factor was 0.944~0.990, and the correlation coefficient between factor and content was > 0.40 (all P< 0.01).

Conclusions
Evidence was found to support the reliability and validity of the aging transformation needs scale that measures the quality of the aging transformation needs for older adults with dementia from an aging transformation needs perspective.