bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bladder drugs and risk of dementia: Danish nationwide active comparator study
Authors: Pourhadi Nelsan , Janbek Janet , Gasse Christiane , Laursen Thomas Munk , Meaidi Amani , Jensen-Dahm Christina , Waldemar Gunhild 
Published: February 2025

ObjectiveTo assess the association between cumulative use of anticholinergic bladder drugs and risk of all cause dementia compared with non-use and use of the β3 agonist bladder drug, mirabegron.DesignDanish nationwide active comparator study.SettingNational Danish registries, 1 January 2000 to 31 December 2022.Participants1 29 254 individuals with dementia were matched by age and sex to 646 270 controls without dementia, identified from a cohort of 2.26 million individuals aged 60-75 years between 2000 and 2022 with no previous dementia. Two separate nested case-control populations were studied: the general population and an active comparator population of 58 242 new users of bladder drugs (2198 developed dementia and were matched to 10 990 controls). Information on medication use was based on filled prescriptions and defined daily doses.Main outcome measuresConditional logistic regression provided incidence rate ratios for associations between anticholinergic bladder drugs and dementia compared with non-use and mirabegron use adjusted for educational level, cardiovascular disease, diabetes, hypertension, dyslipidaemia, and Charlson Comorbidity Index.ResultsCompared with non-use, ever use of anticholinergic bladder drugs was associated with an increased risk of dementia, with an incidence rate ratio of 1.44 (95% confidence interval (CI) 1.40 to 1.48). The incidence rate ratio increased with increasing cumulative drug use, from 1.31 (95% CI 1.27 to 1.36) for 1-90 defined daily doses to 1.68 (1.59 to 1.76) for >365 defined daily doses. Compared with non-use, all types of anticholinergic bladder drugs were associated with increased incidence rate ratios for dementia: tolterodine 1.43 (95% CI 1.38 to 1.49), solifenacin 1.37 (1.29 to 1.46), trospium 1.52 (1.37 to 1.67), and fesoterodine 1.48 (1.26 to 1.74). The increased risk of dementia with use of anticholinergic bladder drugs was not seen when compared directly with the use of the β3 agonist mirabegron (incidence rate ratio 0.82, 95% CI 0.74 to 0.92), irrespective of the type of anticholinergic drug.ConclusionsIn this study, all types of anticholinergic bladder drugs were associated with an increased risk of dementia compared with non-use, but not when applying the active comparator of the β3 agonist bladder drug mirabegron. These findings highlight the relevance of using an active comparator. Future research should evaluate the risk of cognitive impairment and dementia for both types of bladder drugs.
Time-varying effects of COVID-19 vaccination on symptomatic and asymptomatic infections in a prospective university cohort in the USA
Authors: Robinson Lucy , Feting Anna , Isozaki Isamu , Seyfert-Morgolis Vicki , Jay Mitchell , Kim Edward , Cairns Charles 
Published: February 2025

ObjectivesDespite widespread vaccination programmes and consensus recommendations, the understanding of the durability of COVID-19 vaccination against ensuing infection and transmission at the individual level is incomplete. The objective of this study was to estimate the effects of time-varying covariates including time since vaccination and symptoms on subsequent positive SARS-CoV-2 test results and assess the stability of these effects between March 2020 and April 2022.DesignProspective cohort study.SettingUrban university in the USA.ParticipantsDrexel University students, faculty, and staff (n=15 527) undergoing mandatory COVID-19 symptom tracking, testing and vaccinations.InterventionSystematic symptom tracking and SARS-COV-2 testing starting in September 2020 and mandatory COVID-19 vaccination starting in September 2021.Main outcomes and measuresCOVID-19 vaccine effectiveness modified by time since vaccination and symptoms.ResultsUsing fit-for-purpose digitally based symptom and vaccine tracking and mandatory comprehensive testing for SARS-CoV-2 infection, we estimate the time-dependent effects of vaccination, symptoms and covariates on the risk of infection with a Cox proportional hazards model based on calendar time scale. We found a strong protective effect of vaccination against symptomatic infection. However, there was strong evidence of a protective effect against infection only in the first 90 days after completed vaccination, and only against symptomatic versus asymptomatic infection. The overall estimated effect of vaccination within 30 days, including asymptomatic infections, was 37.3% (95% CI 26%, 47%). Vaccine effect modification by reported symptoms and time period was estimated, revealing the protective effect of vaccination within 90 days against symptomatic infection that varied from 90% (95% CI 84%, 94%) to 49%(95% CI −77%, 85%) across time periods.ConclusionsThis study is among the first to prospectively capture complete COVID-19 symptom, testing and vaccination data over a multiyear period. Overall effectiveness of the COVID-19 vaccine against subsequent infection, including transmissible asymptomatic infections, is modest and wanes after 90 days. Vaccination policies may need to take these issues into account.
Association between clinical and pulmonary function features and diagnosis of cough variant asthma: a case–control study
Authors: Ni Kaiwen , Wang Sujie , Zhang Xinlei , Liu Shan , Zhang Ying , Li Yan , Wang Yiting , Yang Junchao 
Published: February 2025

ObjectivesTo compare physical information, such as age, sex, height, weight, body mass index (BMI) and pulmonary function test (PFT) results, between cough variant asthma (CVA) and chronic cough (CC) and establish a diagnostic model of CVA.DesignA case–control study of patients with suspected CVA enrolled at The First Affiliated Hospital of Zhejiang Chinese Medical University.SettingOne leader unit of the National Key Specialised Pulmonary Disease Cooperation Group in China.ParticipantsEnrolled 545 patients who underwent PFT and bronchial provocation tests.Outcome measuresWe obtained physical information and pulmonary test data and established the model using logistic regression analysis. The Hosmer-Lemeshow goodness-of-fit test, area under the receiver operating characteristic curve (AUC), calibration plot and decision curve analysis were used to evaluate this model. All data were analysed using SPSS V.27 and RStudio software.ResultsThe CVA group had more female patients (%) (68.12% vs 51.48%, p value<0.001) and lower height (m) (1.61 (0.40) vs 1.65 (3.26), p value<0.001), weight (kg) (60 (56) vs 63 (85), p value<0.001) and BMI (kg/m2) (22.59 (17.91) vs 23.28 (21.81), p value=0.016) than the CC group. Differences between CVA and CC in forced vital capacity (FVC) in percent predicted values (FVC% pred)(94.4 (57.3) vs 91.60 (94.10), p value=0.006), forced expiratory volume in 1 s/FVC (FEV1/FVC) (%) (84.65±6.82 vs 86.91±6.71, p value<0.001), peak expiratory flow in per cent predicted values (PEF% pred) (93.00 (81.10) vs 98.00 (108.00), p value=0.005), maximal mid-expiratory flow in percent predicted values (MMEF% pred) (74.50 (100.60) vs 90.85 (170.30), p value<0.001), forced expiratory flow (FEF) at 50% of FVC in per cent predicted values (FEF50%pred) (78.9(113.50) vs 93.10(169.80), p value<0.001) and FEF at 75% of FVC in per cent predicted values (FEF75%pred) (69.70 (137.60) vs 85.60 (225.80), p value<0.001) were significant. Patients with CVA were more in number compared with patients with CC at a lower degree (<65%) of MMEF% pred (32.37% vs 14.50%, p value<0.001), FEF50%pred (26.09% vs 13.02%, p value<0.001) and FEF75%pred (39.13% vs 23.67%, p value<0.001). FVC% pred, FEV1/FVC, BMI and MMEF% pred aided in establishing a model with an AUC of 0.733 (95% CI: 0.6829 to 0.7831). The model was tested using internal and external data (p value=0.2865 and p value=0.3197, respectively).ConclusionBMI, FVC% pred, FEV1/FVC (%) and MMEF% pred were used to establish the diagnostic model. Our model potentially indicates CVA.Trial registration numberNCT06199830.
Medication adherence of patients with peripheral arterial disease to antithrombotic therapy: a systematic review
Authors: Wegerif Emilien CJ , Mol Barend M , Ünlü Çağdaş , de Borst Gert J 
Published: February 2025

ObjectivesAntithrombotic therapy (ATT) prevents atherothrombotic events (AE) in patients with peripheral arterial disease (PAD). However, the benefit may be compromised by poor medication adherence (MA). Therefore, our primary objective was the proportion of patients with PAD with poor MA in literature following patient-reported, pharmacy-reported or laboratory-reported outcome measurements. Poor MA is a combined outcome of primary non-adherence (inability to initiate a prescription), secondary non-adherence (incorrect daily intake) and non-persistence (discontinuation of daily intake).DesignSystematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.Data sourcesPubMed, EMBASE and Cochrane Library were searched from 2000 to June 2023.Eligibility criteriaPublications with a (sub)cohort of patients with PAD that reported on patients’ MA to ATT were included.Data extraction and synthesisAll articles were reviewed on eligibility and methodological quality by two independent researchers. The data were retrieved and collected in Review Manager Web and the percentages were calculated per subgroup. The risk of bias was assessed by using the Cochrane risk-of-bias tool for randomised controlled trials (RCT) and the methodological index for non-randomised studies score for non-RCTs.ResultsWe identified 274 potential records of which 10 studies (32 628 patients) were included. Six studies were RCTs and two prospective and two retrospective studies. Most studies scored a moderate risk of bias and had heterogeneous study designs. Poor MA rates ranged between 2% and 45%. Higher rates of poor MA were found in studies with longer follow-ups, pharmacy-reported outcome measurements and registry-based cohorts.ConclusionHeterogeneous study designs create a wide dispersion in the proportions. However, poor MA to ATT was found in approximately one-third of the patients with PAD and seemed to increase with longer therapy duration, which highlights the magnitude of this societal challenge. Enhancing patients’ MA to ATT might be a key element in reducing the risk of AE, and therefore, more attention to MA in clinical and research settings is warranted.PROSPERO registration numberCRD42023431803.
Exploring data security risks associated with trauma medical data within hospitals in China: a qualitative study
Authors: Jin Feifei , Wang Bin , Liao Xiwen , Wang Kai , Huang Wei , Wang Tianbing 
Published: February 2025

ObjectivesTo explore data security risks associated with trauma medical data within hospitals in China, identify and explore the potential underlying factors contributing to these risks and collect suggestions from different stakeholders.DesignThis is a qualitative study involving two types of hospital personnel. Data analysis was performed using thematic analysis.SettingThe study was conducted in 21 tertiary hospitals from 12 provinces in China, distributed across the eastern, central and western regions of the country. The interviews were conducted between April and August 2022.ParticipantsA total of 27 respondents (7 department heads and 20 doctors) were interviewed through stratified purposive sampling.ResultsData security risks associated with trauma medical data might arise from trauma physicians’ inadequate management of trauma data, the absence of trauma data administrators and data management systems and the lack of security measures for trauma databases. Feasible suggestions included training trauma physicians, establishing a trauma data administrator and a trauma data management system and improving basic data security protection measures.ConclusionsDetermining the risks of trauma medical data security and providing tailored suggestions contribute to the development of healthcare data governance in China. This research establishes a foundation for addressing the current risks related to trauma medical data security and could contribute to efforts to improve the overall capacity of trauma data management in China.
Comparative effectiveness and safety of nifedipine and magnesium sulfate as treatment options for preterm birth: a systematic review and meta-analysis
Authors: Fan Jianing , Lu Qianqian , Chen Jie , Lin Pingping , Fan Chong , Lyv Juan , Zhang Yuhan , Wang Xinyan 
Published: February 2025

ObjectivesPreterm birth (PTB) is a major cause of neonatal morbidity and mortality worldwide. Effective use of tocolytic agents may improve perinatal outcomes. This study aims to compare the effectiveness and safety of nifedipine and magnesium sulfate in the treatment of PTB.DesignA systematic review and meta-analysis.Data sourcesChina National Knowledge Infrastructure, China Science and Technology Journal Database, WanFang, PubMed, Embase, Web of Science and Cochrane were searched from inception to 1 December 2024.Eligibility criteriaWe included randomised controlled trials (RCTs) and cohort studies that compare the efficacy and safety of magnesium sulfate versus nifedipine in treating PTB.Data extraction and synthesisTwo researchers independently screened studies and extracted data. Risk of bias was assessed using the Cochrane risk-of-bias assessment tool for RCTs and the modified Newcastle-Ottawa Scale for non-randomised studies. Meta-analysis was conducted using Review Manager V.5.4.ResultsIn all, 50 articles were included in this review, comprising 6072 cases (n=3014 for the magnesium sulfate group; n=3058 for the nifedipine group). Compared with the magnesium sulfate group, the nifedipine group was more favourable in terms of time to onset of action and prolongation of days of gestation, as well as higher neonatal 1 min Apgar scores. The use of magnesium sulfate was associated with a higher incidence of maternal side effects, specifically tachycardia, flushing, palpitations, dizziness and nausea. In addition, the magnesium sulfate group also showed a higher incidence of neonatal respiratory distress syndrome than the nifedipine group.ConclusionCompared with magnesium sulfate, nifedipine is more effective with a faster onset of action and a longer prolonging pregnancy. Additionally, nifedipine may be safer for fewer maternal side effects and better neonatal outcomes. Further studies are needed to confirm the long-term safety and efficacy of these treatments.
Clinical features of overweight in acute-phase hospitalised major depressive disorder with comorbid anxiety: a cross-sectional study
Authors: Zhang Hong , Ma Jun , Wang Jing , Zhu Wenting , Liu Xuebing 
Published: February 2025

ObjectiveThis study aimed to investigate the incidence of overweight in patients with major depressive disorder (MDD) comorbid anxiety during the acute phase and to explore associated factors.DesignCross-sectional study.SettingWuhan Mental Health Center, China, from July 2017 to August 2022.Participants737 hospitalised patients diagnosed with MDD in the acute phase with comorbid anxiety symptoms.Primary outcome measuresIncidence and clinical correlations of overweight (body mass index (BMI) ≥ 24).ResultsAmong the study population, 55.63% were classified as overweight. Binary logistic regression analysis revealed that being married (B=0.28, p value=0.018, OR=1.10), thyroid-stimulating hormone (TSH) levels (B=0.10, p value=0.001, OR=1.10) and low-density lipoprotein cholesterol (LDL-C) levels (B=1.61, p value=0.045, OR=1.18) were significant positive predictors of overweight. Additionally, multiple linear regression indicated that TSH levels (B=0.16, t=3.17, p value=0.002) were positively associated with higher BMI values.ConclusionOver half of the hospitalised MDD patients with comorbid anxiety are overweight. Thyroid function emerges as a crucial clinical factor for overweight in this population. Targeted interventions focusing on thyroid function may be a promising approach for managing overweight in these patients.
Characteristics of patients with COVID-19 and smell and/or taste disorders depending on different virus strains: a cross-sectional study in Hiroshima, Japan
Authors: Ota Yumeka , Yumiya Yui , Chimed-Ochir Odgerel , Hasegawa Aya , Yoshida Takahito , Nagata Tatsuhiro , Tanaka Junko , Ohge Hiroki , Kuwabara Masao , Kubo Tatsuhiko 
Published: February 2025

ObjectiveThe purpose of the study is to compare the prevalence and associated risk factors of smell and/or taste disorders depending on different virus strains in Hiroshima, Japan.DesignA cross-sectional design was used.Setting and participantsData were collected for all COVID-19-confirmed inpatients admitted to 27 hospitals in Hiroshima prefecture, Japan, between 8 April 2020 and 31 January 2023.Main outcome measuresSmell and/or taste disorders were indicated by physicians on Hiroshima prefecture COVID-19 version J-SPEED forms completed at discharge.ResultsThe COVID-19 data from this period corresponds to the following four strains: Wild-dominant, Alpha-dominant, Delta-dominant and Omicron-dominant. A total of 11 353 confirmed cases were analysed and 1261 cases (11.11%) were reported for smell and/or taste disorders.Among patients with Wild-dominant, 241 out of 1141 cases (21.12%) exhibited smell and/or taste disorders. For Alpha, 223 out of 1265 cases (17.63%), for Delta, 480 out of 1516 cases (31.66%) and for Omicron, 317 out of 7431 cases (4.27%) presented with smell and/or taste disorders. For all four variants, age<65 (Wild: adjusted odds ratio [aOR]=2.66, 95% confidence interval [CI]:1.82–3.88; Alpha:aOR=2.00, 95%CI:1.39–2.88; Delta: aOR=2.42, 95%CI:1.54–3.81; Omicron: aOR=1.84, 95%CI:1.40–2.42) were related to smell and/or taste disorders. For the Wild and Delta variants, higher odds of reporting smell and/or taste disorders were found among wmen (Wild:aOR=1.63, 95%CI:1.20–2.22; Delta: aOR=1.41, 95%CI:1.10– 1.80).ConclusionsThe proportion of patients with smell and/or taste disorders varied significantly depending on the virus strain. Our findings indicate that the Delta-dominant period had the highest number of patients with these disorders, while the Omicron-dominant period had the lowest. Moreover, our study identified risk factors for smell and/or taste disorders for each variant.
Effect of vestibular rehabilitation treatment (VRT) on patients with unsteadiness after intratympanic gentamicin in Menière’s disease: protocol for a randomised controlled trial
Authors: Tong Qiling , Zhou Yue , Wu Peixia , Yu Huiqian 
Published: February 2025

IntroductionMenière’s disease (MD) is a multifactorial disease characterised by recurring vertigo, tinnitus and fluctuating sensorineural hearing loss as typical clinical symptoms. For patients with MD with poor response to non-invasive treatments, it is recommended to use intratympanic gentamicin treatment. The destruction of vestibular organs by gentamicin may cause residual vestibular symptoms, notably unsteadiness. However, most previous clinical studies paid little attention to this issue. Currently, vestibular rehabilitation treatment (VRT) has been proven to be an effective method for controlling vestibular symptoms and has been applied to patients with various vestibular diseases. The aim of this study is to investigate the efficacy of VRT versus usual care in MD patients who experience persistent unsteadiness for 1 month after intratympanic gentamicin treatment, in order to understand whether VRT has a positive impact on balance maintenance and vertigo control in patients with MD.Methods and analysisRandomised, assessor-blinded, controlled clinical trials will be used to compare the efficacy of balance function before and after VRT. Patients with MD who experience chronic unsteadiness for 1 month after intratympanic gentamicin treatment will be recruited and receive VRT, mainly including gaze stability training, gait rehabilitation, vestibular habituation training, etc. The outcomes assessments will be conducted at baseline and at eighth week and sixth month post-randomisation. The primary outcome will be the improvements in vestibular function quantified through the Functional Gait Assessment. The secondary outcomes will include sensory organisation test, vestibular laboratory tests (video head impulse test, caloric test and vestibular evoked myogenic potentials), Menière’s disease outcomes questionnaire, visual vertigo analogue scale and vestibular activities and participation measure.Ethics and disseminationThis trial received ethical approval from the Institutional Review Board of Eye and ENT Hospital of Fudan University (reference number 2024020). The study results will be disseminated via peer-reviewed journals and conferences.Trial registration numberNCT06143462.
Temporal changes in blood biomarkers associated with sleep apnoea severity: a retrospective cohort study in Finland
Authors: Hellen Mira , Ruoranen Toni , Toppila-Salmi Sanna , Vasankari Tuula , Kreivi Hanna-Riikka , Mattila Tiina , Ollila Hanna M , Strausz Satu 
Published: February 2025

IntroductionObstructive sleep apnoea (OSA) is a common sleep disorder associated with breathing interruptions during sleep, often leading to oxygen level drops and sleep disturbances. OSA is known to impact various physiological parameters, including haematological and lipid profiles. This study aims to investigate the effect of continuous positive airway pressure (CPAP) therapy on laboratory values in patients with OSA.MethodsA retrospective study was conducted using data from Finland’s largest hospital district, including 30 722 adult OSA patients treated between 2005 and 2020. A text search algorithm was implemented within the patient chart data to extract the apnoea-hypopnoea index (AHI) and the usage of CPAP therapy, along with identifying patients who had declined treatment. Haematological and metabolic laboratory values were collected 3 years before and after the first OSA diagnosis. Analysis of covariance was employed to compare parameter variations across severity levels, adjusted for age, sex and body mass index (BMI). T-test for repeated measurements was used to analyse the differences between data, 3 years prior and 3 years after the first OSA diagnosis.ResultsThe study of 30 722 OSA patients showed varying severity levels: 14.8% mild, 32.6% moderate and 52.6% severe, with an average diagnosis age of 55.0 years and a mean BMI of 32.4. The most clinically significant changes were observed in lipid profile markers, with improvements in cholesterol and low-density lipoprotein (LDL) levels (p value<0.05), measured before CPAP treatment initiation and after the treatment began. Conversely, glucose levels increased during the follow-up period. Similarly, haematocrit and haemoglobin decreased significantly after initiation of the CPAP treatment. In sex-specific analyses, significant improvements in cholesterol and LDL levels were found in both sexes. Triglyceride levels improved in male patients, in contrast with female participants, whose triglyceride levels increased during the follow-up period.ConclusionsCPAP therapy significantly improves cholesterol and LDL levels in both sexes and reduces haematocrit and haemoglobin levels. This study highlights the systemic effects of OSA and underscores the importance of evaluating haematological and lipid profiles in OSA management.