bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is diagnostics of Benign Paroxysmal Positional Vertigo with a mechanical rotation chair superior to traditional manual diagnostics? A randomized controlled crossover study
Authors: Hentze Malene , Hougaard Dan Dupont , Kingma Herman 
Published: December 2024

BackgroundBenign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo. While various techniques and technologies have improved BPPV diagnostics and treatment, optimizing BPPV healthcare pathways requires a comprehensive understanding of the diagnostic modalities across diverse clinical settings.ObjectiveTo compare traditional manual BPPV diagnostics (MD) with diagnostics done with the aid of a mechanical rotation chair (MRC) when using videonystagmography goggles with both modalities.MethodsThis prospective, open-label, randomized diagnostic crossover study involved 215 adults with typical BPPV symptoms at a tertiary University Hospital-based outpatient clinic (Aalborg University Hospital, Denmark). Participants referred by general practitioners or otorhinolaryngologist clinics underwent both traditional manual and MRC diagnostics with the aid of videonystagmography goggles. The order of the diagnostic modalities was randomly assigned, and the two modalities were separated by a minimum of 30 min. The primary outcomes included sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of traditional MD compared to MRC diagnostics. The secondary outcome was the agreement between the two modalities.ResultsThe MRC demonstrated a significantly higher sensitivity for BPPV detection in general for all participants (p = 0.00). Compared to MRC diagnostics, traditional MD displayed a sensitivity of 69.5% (95% confidence interval (CI): 59.8–78.1), specificity of 90.9% (95% CI: 83.9–95.6), PPV of 88.0% (95% CI: 83.9–95.6), and NPV of 75.8% (95% CI: 67.5–82.8). The overall inter-modality agreement was 80.5% (95% CI: 75.2–85.8, Cohen’s kappa 0.61). While both modalities detected unilateral posterior canal BPPV equally good (p = 0.51), traditional MD underperformed for non-posterior BPPV (significantly) and in subgroups referred by ENTs (trend) or with impaired cooperation during traditional MD (significantly).ConclusionTraditional manual BPPV diagnostics remains a valuable first-line approach for most patients. However, MRC diagnostics offers advantages for complex BPPV cases, patients with impaired cooperation, patients referred from otorhinolaryngologist clinics, and those with negative traditional MD but an evident BPPV history. MRC may be useful as a second opinion diagnostic tool for treatment-resistant BPPV.Clinical trial registrationClinicalTrials.gov identifier: NCT05846711.
Risk factors and simple scoring system for predicting postoperative nutritional status of Hirschsprung’s disease
Authors: Die Xiaohong , Feng Wei , Song Aohua , Liu Wei , Wang Yi , Guo Zhenhua , He Dawei 
Published: December 2024

BackgroundNutritional problem after surgery for Hirschprung’s disease (HSCR) was not optimistic. This study aimed to analyze the risk factors of postoperative undernutrition for patients with HSCR and establish a scoring system for predicting postoperative undernutrition.MethodsRetrospective review of 341 patients with HSCR who received Laparoscopic-assisted pull-through surgery in a tertiary-level pediatric hospital was conducted with assessments of clinical data. Univariate/multivariate Logistic regression analysis was used to identify independent factors of postoperative undernutrition, and establish a scoring system for predicting postoperative nutritional status based on the sum of adjusted odds ratios (ORs).ResultsThe postoperative undernutrition of 341 patients with HSCR was 29.9%. Multivariate Logistic regression analysis showed that non-breast feeding (mixed: OR = 6.116, artificial: OR = 12.00), preoperative undernutrition (risk of malnutrition: OR = 7.951, malnutrition: OR = 8.985), non-parental caregivers (OR = 3.164), long-segment HSCR (OR = 12.820), postoperative complications within 30 days (grade 1 ~ 2: OR = 2.924, Grade 3 ~ 4: OR = 6.249), and surgery for other systemic malformation (OR = 5.503) were risk factors for postoperative undernutrition (all p &lt; 0.05), and scoring system was developed based on these determinants. The area under the receiver operator characteristic curve of the derivation sample was 0.887 (95% confidence interval [CI]: 0.839–0.934) and that of the validation sample was 0.846 (95% CI: 0.772 ~ 0.920) with the optimal cut-off value of 12; calibration curves of the derivation sample showed considerable predictive performance for postoperative undernutrition.ConclusionRisk factors identified affecting postoperative undernutrition should be taken seriously in patients with HSCR. We successfully developed a desirable scoring system to predict postoperative nutritional status, which might be helpful for clinical practice.
Factors influencing concurrent wasting, stunting, and underweight among children under five who suffered from severe acute malnutrition in low- and middle-income countries: a systematic review
Authors: Dassie Godana Arero , Chala Fantaye Tesfaye , Charkos Tesfaye Getachew , Sento Erba Midhakso , Balcha Tolosa Fufa 
Published: December 2024

BackgroundWasting, stunting, and underweight in children are complex health challenges shaped by a combination of immediate, underlying, and systemic factors. Even though copious data demonstrates that the causation routes for stunting and wasting are similar, little is known about the correlations between the diseases in low- and middle-income nations.ObjectiveThe objective of this study is to evaluate the factors that concurrently affect wasting, stunting, and underweight in &lt;5-year-olds with severe acute malnutrition (SAM).MethodThis review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched every electronic database that was available, from the medRxiv pre-print site, PubMed, MEDLINE, EMBASE, Cochrane Library, Web of Science, PsycINFO, CINAHL, Google Scholar, and Scopus, in addition to the Science Direct search engine. We considered research conducted in low- and middle-income nations on &lt;5-year-olds with SAM. The Newcastle Ottawa Scale was used to assess the quality of the studies.ResultsAfter screening and selecting 12 eligible studies, 1,434,207 records were included for analysis. The prevalence of factors influencing concurrent wasting, stunting, and being underweight was 26.42% in low-middle -income countries (LMI). The prevalence was higher in men, with wasting, stunting, and underweight at 14.2, 4.1, and 27.6%, respectively. Unprotected drinking water was associated with stunting [odds ratio = 0.68; 95CI (0.50, 0.92)]. Being male is another factor (aOR = 2.04, 95% CI: 1.13, 3.68). Lack of prenatal care follow-up was associated with a lower risk of wasting (OR = 2.20, 95% CI: 1.04, 4.64), while low birth weight (&lt;2.5 kg), diarrhea, having a younger child, and being from a poor household were associated with wasting, stunting, and underweight. Other factors included body mass index (BMI) for age aOR = 2.11, 95% CI: (0.07, 0.895); maternal education: stunting [aOR = 1.52, 95% CI: (0.09, 0.89)], underweight [aOR = 1.97, 95% CI: (0.01, 0.73)], and open defecation, stunting [aOR = 1.62, 95% CI: (0.06, 0.32)], underweight [aOR = 1.92, 95% CI: (0.042, 0.257)]). Likelihood of being underweight increased with birth order (second born, aOR = 1.92, 95% CI 1.09–3.36; third born, aOR = 6.77, 95% CI 2.00–22.82).ConclusionInadequate dietary intake, illness, food insecurity, poor maternal and child care, poor hygiene and sanitation, and healthcare inaccessibility contribute to SAM.
Dietary antioxidant index and hypertension in the Iranian population: a nested case–control study within the Fasa adults cohort study
Authors: Firooznia Mohammad amin , Rahimlou Mehran , Sekhavati Eghbal , Motazedian Mohammadreza , Tabrizi Reza 
Published: December 2024

IntroductionHypertension (HTN) is a prevalent condition associated with numerous cardiovascular and non-cardiac complications. Lifestyle interventions, including dietary adjustments, offer promising avenues for hypertension management. However, the precise relationship between dietary antioxidants and hypertension risk necessitates further investigation. This study aimed to elucidate the association between the Dietary Antioxidant Index (DAI) and hypertension risk using a nested case–control design.MethodA matched nested case–control study was conducted within the Fasa Adult Cohort Study (FACS), comprising 975 participants aged 35–70 years. Cases (n = 325) were hypertensive patients, while controls (n = 650) were individuals without hypertension, matched for sex and age. Dietary intake was assessed using a validated food frequency questionnaire, and DAI was computed based on standardized intake of antioxidants. Conditional logistic regression models were employed to evaluate the association between DAI and hypertension risk, adjusting for confounding variables.ResultsA significant inverse correlation was observed between DAI and hypertension risk across all models (OR = 0.89; 95% CI = 0.86–0.93, p &lt; 0.001). This association remained robust after adjusting for potential confounders, including BMI, smoking, lipid profile, blood glucose levels, and educational status. In conclusion, higher DAI values were associated with a reduced risk of hypertension, highlighting the potential benefits of antioxidant-rich diets in hypertension prevention.ConclusionThese findings underscore the importance of dietary interventions as a complementary approach to hypertension management.
A higher global diet quality score is associated with lower risk of obesity among male university students in Lebanon: a pilot study
Authors: Mourad Najwa , Kharroubi Samer , Nasreddine Lara , Hwalla Nahla 
Published: December 2024

ObjectiveThis pilot study aims to assess the diet quality amongst Lebanese male university students using the Global Diet Quality Score (GDQS), identify its association with obesity, and determine the key drivers of consumption of foods associated with higher NCDs risk.MethodsA cross-sectional survey was conducted using a convenience sampling approach, comprising 385 male students aged between 18 and 24 years at the American University of Beirut. Dietary data was collected using 24-h recall, where participants detailed all foods and beverages consumed in the past 24 h, including portion sizes. Sociodemographic, anthropometric, lifestyle factors and drivers of food consumption data were also collected. GDQS scores were categorized as high (≥23), moderate (15–23), or low (&lt; 15) indicating low, moderate and high NCD risk, respectively. A multiple logistic regression was applied to assess association of GDQS with sociodemographic and anthropometric variables.ResultsThe results showed that the majority of male university students had low (47%) or moderate (47%) GDQS scores, with only a small proportion (4%) showing high scores. Foods contributing to low GDQS scores were determined, with taste emerging as the primary factor influencing food group consumption. Additionally, individuals in health-related majors and higher academic year of study had higher GDQS scores, and those with higher GDQS scores had a lower risk of obesity. The study findings suggest that a high proportion of the study sample are at a higher risk of NCDs given their dietary quality, demonstrated an association between low GDQS scores and obesity risk, and identified education as a predictor of diet quality.ConclusionThis study calls for larger studies assessing dietary habits and quality amongst Lebanese university students to provide context-specific evidence for the development of targeted interventions aimed at the promotion of healthier eating habits in this population group and curbing the NCDs epidemic in the country.
Association between oxidative balance score and serum cobalt level in population with metal implants: a cross-sectional study from NHANES 2015–2020
Authors: Yuan Wenxiu , Chen Jing , Sun Jun , Song Chenyang , Chen Zhi 
Published: December 2024

BackgroundGrowing evidence indicates that metal implants influence the body’s oxidative stress status, which in turn affects the degradation and stability of metal implants. The oxidative balance score (OBS) is a composite indicator, reflecting the overall oxidative balance of pro-and antioxidants of the human body. However, the associations between OBS and the level of metal ions on the population with metal implants remain to be elucidated.MethodsWe conducted a cross-sectional study using data from 2015 to 2020 National Health and Nutrition Examination Survey (NHANES). Dietary and lifestyle factors closely associated with oxidative stress were quantified to calculate the OBS. Weighted multivariate logistic regression and smooth curve fittings were performed to examine the relationship between OBS and serum cobalt levels. Subgroup analyses were stratified by age and gender. In cases where non-linearity was detected, threshold effects were assessed using a two-piecewise linear regression model.ResultsA total of 549 participants were included in this analysis. The dietary OBS was negatively associated with serum cobalt level in fully adjusted model (β = −0.179, 95%CI: −0.358 to −0.001, P: 0.04918). Stratified by age and gender, negative correlation of OBS and dietary OBS with serum cobalt level was observed only in men and age over 70 years participants. Threshold effect analysis showed linear relationships between OBS, dietary OBS and cobalt level in males. There were non-linear relationships between OBS, dietary OBS and cobalt level in age over 70 years participants, with inflection points identified at 16.3 and 8.7 for OBS and dietary OBS, respectively.ConclusionOur study confirms the inverse relationships between oxidative stress and serum cobalt level in individuals with metal implants, highlighting the significance of optimizing OBS to mitigate the risk of metal ion toxicity. These findings emphasize the importance of maintaining an antioxidant diet and lifestyle, particularly as they offer greater protective effect for males and the elderly population.
Postoperative complications after central nervous system tumor resection in pediatric patients admitted to an intensive care unit in Colombia
Authors: Lasso-Palomino Rubén E. , Gómez Inés Elvira , Soto-Aparicio María José , Gempeler Andrés , Pombo-Jiménez Andrés , Gómez-Toro Melissa , Rojas-Robledo Valentina , Jiménez-Arévalo María Alejandra , Bastidas-Toro Karla Alejandra , Sierra Jimena , Martínez-Betancur Sofía , Ariza-Insignares Camila , Montaño-Vivas Isabella , Castro Ximena , Arias Anita V. 
Published: December 2024

IntroductionCentral nervous system (CNS) tumors are the second most prevalent malignant neoplasms in childhood, with surgical resection as the primary therapeutic approach. The immediate postoperative period following CNS tumor resection requires intensive care to mitigate complications associated with high morbidity and mortality. ObjectiveThe primary aim of this study is to comprehensively describe the postoperative complications observed in pediatric patients who underwent primary CNS tumor resection and were subsequently admitted to the pediatric intensive care unit (PICU) at Hospital Universitario Fundación Valle del Lili in Colombia.MethodsWe conducted a cross-sectional observational analysis of pediatric patients who underwent surgery for CNS tumors and were admitted to our PICU from January 2011 to December 2021. Clinical, histopathologic, and postoperative complication data were collected. A descriptive statistical analysis was performed using measures of dispersion and central tendency with a 95% confidence interval.ResultsA total of 114 patients were included, of whom 55.3% were male. The median PICU stay was 4 days (2–7). The most common tumor type was embryonal (25.4%), followed by low-grade glioma (20.1%) and high-grade glioma (14.9%). Mechanical ventilation was required in 24.5% of patients, with a median extubation time of 3 days (2–9). In the immediate postoperative period, 6.14% of patients experienced CNS hemorrhage and 3.5% experienced intracranial hypertension. Common complications included motor deficits, facial paralysis, and sensory deficits. The mortality rate was 3.5%.ConclusionThis study describes the postoperative complications, clinical challenges, and interventions observed in pediatric patients after CNS tumor resection in a resource-limited country. Our findings emphasize the importance of tailored interventions and multidisciplinary collaboration to optimize clinical outcomes. Future data comparison from centers sharing similar characteristics will play a crucial role in identifying best practices and enhancing outcomes globally.
Protective effect of Haoqin Qingdan decoction on pulmonary and intestinal injury in mice with influenza viral pneumonia
Authors: Lin Xi , Lin Jian , Ji Lichun , Zhang Jiaona , Zhang Yezi , Hong Junbin , Li Geng , Lin Xingdong 
Published: December 2024

BackgroundHaoqin Qingdan decoction (HQQD), composed of eleven herbs, is a traditional Chinese formula widely recognized for its efficacy in treating pulmonary inflammation induced by viral infections. Despite its extensive use, the potential pulmonary and intestinal protective effects of HQQD on influenza viral pneumonia (IVP) and the underlying molecular mechanisms remain unclear.Materials and MethodsUltra-high-performance liquid chromatography coupled with mass spectrometry (UHPLC-MS) was employed to identify the major chemical constituents of the prescription. Subsequently, network analysis was conducted to predict the potential therapeutic targets of HQQD in IVP. The mechanisms by which HQQD mitigates lung and intestinal damage were further elucidated by assessing NP protein expression, inflammatory factors, TLR7/MyD88/NF-κB signaling pathway mRNAs and proteins, and through intestinal flora analysis.ResultsThe protective effects of HQQD on pulmonary and intestinal injuries induced by IVP were thoroughly investigated using comprehensive network analysis, signaling pathway validation, and gut microflora analysis. UHPLC-MS analysis identified the primary chemical constituents. Validation experiments demonstrated a significant reduction in NP protein expression in the lungs. HQQD notably alleviated immune damage in the lungs and intestines of mice by inhibiting NP protein expression and the release of inflammatory factors such as interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ); downregulating the expression levels of TLR7, MyD88, and phospho-NF-κB p65 (p-p65); lowering serum LPS levels; and reducing the relative abundance of Proteobacteria.ConclusionHQQD exerts therapeutic effects against influenza viral pneumonia through antiviral and anti-inflammatory mechanisms and by remodeling the intestinal flora. This study provides initial insights into the “gut-lung” axis mechanism of HQQD in combating respiratory influenza virus infection.
Despite the pandemic: upward trajectories of medication adherence and persistence in patients with dyslipidemia
Authors: Jang Jieun , Oh Hyun Jung , Lee Eui-Kyung 
Published: December 2024

BackgroundDyslipidemia, a major cardiovascular risk factor, requires consistent medication adherence, but new patients often struggle due to its asymptomatic nature. The COVID-19 pandemic has disrupted global healthcare. This study examined its impact on medication adherence and persistence among Korean patients with dyslipidemia (PWD), comparing the effects on new versus existing PWD.MethodNationwide claims data were used to identify PWD and their prescribed medications. Patients were categorized as new or existing PWD and matched 1:1 using propensity scores in both the pre- and post-COVID-19 periods. Medication adherence was measured by the proportion of days covered (PDC), and persistence was assessed by analyzing gaps in continuous medication dispensing. The impact of COVID-19 was evaluated using multiple regression and Cox proportional hazard models.ResultThe pre-COVID-19 cohort included 519,696 patients, and the post-COVID-19 cohort comprised 536,762 patients. PDC significantly increased post-COVID-19, with existing PWD showing a larger increase by 4.74 units (p &lt; 0.0001), compared with 2.01 units for new PWD (p &lt; 0.0001). Both groups exhibited lower risks of medication discontinuation, with a greater decrease observed in the existing PWD (hazard ratio [HR] 0.780, 95% confidence interval [CI] [0.774–0.786], p &lt; 0.0001), compared with the new PWD (HR 0.929, 95% CI [0.923–0.934], p &lt; 0.0001). New PWD had fewer annual visits, whereas existing PWD had more visits (both p &lt; 0.0001).ConclusionDespite the COVID-19 pandemic, medication adherence and persistence improved in both new and existing PWD. Notably, new patients with no prior treatment experience showed weaker positive responses, highlighting the potential need for targeted interventions to support new patients during public health crises.
Psychometric properties of the pain anxiety symptom scale among postoperative patients in Amol, Iran
Authors: Sharif-Nia Hamid , Froelicher Erika Sivarajan , Marôco João , Hoseinzadeh Esmaeil , Hejazi Sima , Fatehi Reza , Nowrozi Poorya , Mohammadi Bita 
Published: December 2024

IntroductionSo far, the psychometric properties of the Persian version of the Pain Anxiety Symptom Scale have not been assessed in Iran. Therefore, this study was conducted to determine the validity and reliability of the Persian version of the Pain Anxiety Symptom Scale among a group of Iranian patients in Amol.MethodsThis methodological study was conducted in 2023 with a sample of 400 postoperative patients from Amol, Iran, selected through convenience sampling. The dataset was divided into two groups of 200 for exploratory and confirmatory factor analyses. Construct validity was assessed using maximum likelihood exploratory factor analysis with Promax rotation, supported by Horn’s parallel analysis and network analysis to visualize item relationships. Confirmatory factor analysis, convergent and discriminant validity was performed on the second dataset. Reliability was evaluated through various statistical measures, including Cronbach’s alpha, McDonald’s omega, average inter-item correlation coefficient, composite reliability, and maximal reliability (MaxR).ResultsAmong the 400 participants, the mean age was 44.38 years (SD = 13.49), with 152 (46.1%) being women and 178 (53.9%) men. Most participants (n = 268, 81.2%) had an education level lower than a diploma, and 93 individuals (28.2%) reported a history of surgery. The results of exploratory factor analysis with Promax rotation developed two factors accounting for 66.29% of the variance comprising 15 items. Also, after necessary modifications during confirmatory factor analysis, the final model was approved. As for reliability, the Cronbach’s alpha, composite reliability, and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability.ConclusionAccording to the results, the Persian version of the Pain Anxiety Symptom Scale has a valid structure and acceptable reliability. This scale can be used by health professionals in many ways.