bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors leading to the trajectory of cognitive decline in middle-aged and older adults using group-based trajectory modeling: A cohort study
Authors: Su Jun , Xiao Xiaohua
Published: November 2022

Currently, studies exploring factors associated with the cognition at some time point and no study identifying the trajectories of cognitive changes and factors might associate with the trajectories of cognitive changes in people. This study was to identify factors associated with the trend of cognitive decline in middle-aged and older people. In this cohort study, the data of 6954 subjects were collected from China Health and Retirement Longitudinal Survey database. Group-based trajectory modeling was applied for identifying three different trajectories of cognitive function change [high initial level and slow decline group (n = 1024), moderate initial level and moderate decline group (n = 2673) and low initial level and rapid decline (LRD) group (n = 3277)]. Univariate and multivariate logistic regression analysis was conducted to identify variables influencing factors of the trajectories of cognitive function in middle-aged and older people. The follow-up interval was 2 years from 2011 to 2015, and 3 years from 2015 to 2018 via face-to-face interview. High initial level and slow decline group versus LRD group, age (OR = 2.591, 95% CI: 1.962–3.421), gender (OR = 1.398, 95% CI: 1.133–1.725), education (OR = 0.051, 95% CI: 0.039–0.068), place of residence (OR = 2.768, 95% CI: 1.663–4.606), disabled (OR = 1.557, 95% CI: 1.189–2.039), family annual income (OR = 0.757, 95% CI: 0.618–0.929), sleep duration (OR = 1.266, 95% CI: 1.023–1.567), instrumental activity of daily living impairment (OR = 2.513, 95% CI: 1.947–3.245), community activities participation (OR = 0.611, 95% CI: 0.500–0.748), depression (OR = 1.471, 95% CI: 1.185–1.828), and systolic blood pressure (OR = 1.005, 95% CI: 1.001–1.009) were factors influencing the trajectories of cognitive function. Comparing moderate initial level and moderate decline group and LRD group, age (OR = 1.245, 95% CI: 1.052–1.474), gender (OR = 1.244, 95% CI: 1.062–1.458), education (OR = 0.244, 95% CI: 0.190–0.314), marital status (OR = 1.291, 95% CI: 1.079–1.546), place of residence (OR = 1.677, 95% CI: 1.358–2.071), disability (OR = 1.396, 95% CI: 1.180–1.652), smoking (OR = 1.249, 95% CI: 1.071–1.457), family annual income (OR = 0.863, 95% CI: 0.768–0.970), sleep duration (OR = 1.215, 95% CI: 0.973–1.541), instrumental activity of daily living impairment (OR = 1.309, 95% CI: 1.098–1.560), community activities participation (OR = 0.804, 95% CI: 0.718–0.900) and depression (OR = 1.383, 95% CI: 1.217–1.571) were factors associated with the trajectories of cognitive function changes. Middle-aged and older adults who had characteristics associated with increased risk of cognitive decline might be provided with timely interventions.
Perioperative blood glucose variability and autonomic nervous system activity in on-pump cardiac surgery patients: Study protocol of a single-center observational study
Authors: Chazal Etienne , Parmentier Anne-Laure , Pili-Floury Sebastien , Bouhaddi Malika , Borot Sophie , Perrotti Andrea , Vettoretti Lucie , Trajkovski Julian , Ferreira David , Zanoni Chloe , Samain Emmanuel , Besch Guillaume , Salomon du Mont Lucie
Published: November 2022

Introduction:

On-pump coronary artery bypass graft (CABG) and surgical valve replacement (SVR) are high-risk procedures. Several studies reported that perioperative blood glucose (BG) variability was independently associated with impaired postoperative outcome. However, the underlying mechanisms contributing to increased perioperative BG variability and to its deleterious impact remain unknown. The hypothesis of the study is that perioperative BG variability could be related to perioperative alteration of the autonomic nervous system (ANS) activity and to preoperative BG variability.

Methods and analysis:

We designed a prospective observational single-center study. Four groups of 30 patients will be studied: group 1, including insulin-requiring type 2 diabetic patients undergoing on-pump CABG; group 2, including non-insulin-requiring type 2 diabetic patients undergoing on-pump CABG; group 3, including non-diabetic patients undergoing aortic SVR; and group 4, including non-diabetic patient undergoing on-pump CABG. Preoperative (baseline) and postoperative BG variability will be quantified using the Abbott’s Freestyle Libre Pro sensor allowing for continuous subcutaneous BG monitoring. Preoperative (baseline) and postoperative ANS activity will be measured using noninvasive continuous heart rate monitoring (Mooky HR memory®). Blood level and urinary concentration of inflammatory and endothelial dysfunction biomarkers will be measured from blood and urinary samples at the end of the surgery and on postoperative day 1 and 2. The primary objective is to describe the relationship between baseline BG variability and postoperative BG variability. The secondary objectives are to describe the relationship: between baseline and postoperative BG variability according to the diabetes phenotype and to the type of surgery; between the ANS activity and the BG variability; and between postoperative BG variability and, urinary and blood biomarkers.
Tuina for shoulder pain after stroke: A protocol for systematic review and meta-analysis
Authors: Sun Weichen , Ji Guangcheng , Lu Longman , Sun Jiabao , Guo Haoze , Yao Yao , Gao Shan , Li Jing , Chen Jinjin , Song Bailin
Published: November 2022

Background:

Post-stroke shoulder pain is a relatively common complication in stroke patients, with an incidence of 16% to 84% and poor outcomes with anti-inflammatory or sedative medications. This study will evaluate the results of a randomized controlled trial to determine the effectiveness and safety of Tuina in the treatment of post-stroke shoulder pain.

Methods:

The Chinese and English search strategies were used to search China National Knowledge Infrastructure, Chinese Scientific Journal Database, Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, PubMed, Wanfang Database, and Web of Science were used to search seven databases. All eligible studies published on or before September 15, 2022, will be selected. To improve the validity of this study, only clinical randomized controlled trials related to the use of Tuina for post-stroke shoulder pain will be included. The screening will be performed by 2 independent reviewers and data synthesis, bias analysis, subgroup analysis, and meta-analysis will be performed using RevMan (V.5.4) software.

Results:

The study will provide a high-quality evaluation of the effectiveness and safety of Tuina in the treatment of post-stroke shoulder pain.

Conclusion:

This systematic review will provide evidence to determine whether Tuina is an effective and safe intervention for treating patients with post-stroke shoulder pain.

PROSPERO registration number: CRD42022360401.
Efficacy of a topical formulation containing MIA (Melanoma Inhibitory Activity) ‐ Inhibitory peptides in a case of recalcitrant vitiligo in combination with UV exposure
Authors: Hernandez Navarro Sergi , Segura Tejedor Jordi , Bajona Roig Marta , Luisetto Roberto , Fedrigo Marny , Castellani Chiara , Angelini Annalisa , Alaibac Mauro , Bordignon Matteo
Published: November 2022

Introduction:

Vitiligo is an acquired chronic pigmentation disorder of the skin. Even if the role of the immune system seems to be well established, new pathogenetic hypothesis are rising in these years. It has been recently suggested by the development of an animal model that a protein called Melanoma Inhibitory Activity (MIA) is involved in the pathogenesis of vitiligo. This protein interacts with the adhesion molecules expressed on the melanocytes causing its detachment from extracellular matrix proteins and creating the depigmented macules. A topical preparation based on oligopeptides able to inhibit the actions of the MIA protein has been introduced to the market, claiming activity on vitiligo.

Patient concerns and diagnosis:

A patient affected by non-segmental vitiligo for 10 years, recalcitrant to any treatment (such as steroids, immunomodulators, kellin, UVB-NB and UVA) came to our observation.

Interventions:

We used this topical preparation containing the MIA inhibitors peptides in selected areas (face and sides of the trunk) leaving untreated other areas as control (legs and arms). The patient was required to be sun exposed or to have some UVA sessions during the treatment to stimulate the melanocytes replications.

Outcomes:

After 9 months of treatments, he recovered from 50% to 80% of repigmentation only in the treated areas, without any side effects locally or systemically.

Conclusion:

Even if other studies are required to better determine the efficacy of this approach, this first observation about the use of the MIA-inhibitors peptides for the treatment of non-segmental vitiligo indicates that this topical preparation containing the MIA inhibitors peptides could be a very promising option for the cure of this disease.
The efficacy of heart rate variability biofeedback in patients with acute ischemic stroke: A protocol for systematic review and meta-analysis
Authors: Xie Lihua , Zhang Chunyan , Zhang Junling , Zhao Min
Published: November 2022

Background:

Stroke is the most common serious neurological disorder, and in high-income countries, it is the fourth-leading cause of death, long-term disability, and reduced quality of life among adults. Heart rate variability (HRV) can improve autonomic dysfunction, cognitive impairment, and psychological distress in other patient populations, but its effect in patients with acute ischemic stroke is still unclear. We conducted a protocol for systematic review and meta-analysis to evaluate the efficacy of HRV biofeedback in patients with acute ischemic stroke.

Methods:

A computerized literature search will be performed in the following electronic databases from their inceptions to October 2022: PubMed, EMBASE, MEDLINE, Cochrane Central Register of Controlled Clinical Trials, China Knowledge Resource Integrated Database, Wanfang Data Information, and Weipu Database for Chinese Technical Periodicals. The risk of bias in the included articles is assessed according to the Risk of Bias Assessment Tool in Cochrane Handbook of Systematic Reviews. Data are analyzed with the Review Manager Version 5.3 software.

Results:

This paper will provide high-quality synthesis to assess the efficacy of HRV biofeedback in patients with acute ischemic stroke.

Conclusion:

HRV biofeedback may be a promising intervention for improving autonomic function, cognitive impairment, and psychological distress in patients with acute ischemic stroke.
Clinical characteristics and risk factors for kidney failure in patients with autosomal dominant polycystic kidney disease: A retrospective study
Authors: Park Hanil , Paek Jin Hyuk , Kim Yaerim , Park Woo Yeong , Han Seungyeup , Jin Kyubok
Published: November 2022

Autosomal dominant polycystic kidney disease (ADPKD) is a hereditary and progressive renal disease. By the age of 65 years, 45% to 70% of patients with ADPKD reach end-stage renal disease (ESRD). Although there are various treatments for this condition, no standard therapy exists to delay the progression of ADPKD. Hence, understanding the factors that affect disease progression may be helpful for the treatment of ADPKD. The medical records of 288 patients with ADPKD at Keimyung University Dongsan Medical Center between January 1989 and August 2018 were analyzed retrospectively. Furthermore, we inspected the risk factors involved in the progression of ADPKD and the kidney survival rates of patients using the Cox proportional hazards model and Kaplan–Meier survival analysis. The mean age at the time of diagnosis was 43.1 ± 14.1 years, and there were 146 males (50.7%). In total, 197 patients (68.4%) had hypertension and 11 patients (3.8%) had cerebral aneurysm. Stroke occurred in 35 patients (12.1%), including 11 cases of cerebral hemorrhage and 24 cases of cerebral infarction. Twenty-eight patients (9.7%) died during the follow-up period (117.1 ± 102.1 months). Infection (42.9%) was the most common cause of mortality, followed by sudden cardiac death (25.0%). Overall, 132 patients (45.8%) progressed to ESRD and 104 patients (36.1%) required renal replacement therapy (RRT). The mean duration from diagnosis to RRT was 110.8 ± 93.9 months. Age at diagnosis after 30 years (odd’s ratio [OR], 2.737; 95% confidence interval [CI], 1.320–5.675; P = .007), baseline serum creatinine levels (OR, 1.326; 95% CI, 1.259–1.396; P < .001), and cyst infection (OR, 2.065; 95% CI, 1.242–3.433; P = .005) were the independent risk factors for kidney failure in multivariable analysis. To delay the advance of ADPKD to ESRD, early diagnosis and close observation for the onset of cyst infection are crucial.
LncRNA DIRC1 is a novel prognostic biomarker and correlated with immune infiltrates in stomach adenocarcinoma
Authors: Lin Yuning , Zhang Zhongying , Li Ying , Chen Yongquan , Su Meiying , Zhao Wenzhen
Published: November 2022

The potential application value of Long non-coding RNA disrupted in renal carcinoma 1 (DIRC1) has not yet been explored, the purpose of this study was to explore the relationship between DIRC1 and stomach adenocarcinoma (STAD) based on the cancer genome atlas database. Wilcoxon rank sum test, Chi-square test, Fisher test and logistic regression were used to evaluate relationships between clinical-pathologic features and DIRC1 expression. Receiver operating characteristic (ROC) curves were used to describe binary classifier value of DIRC1 using area under curve (AUC) score. Kaplan-Meier method was used to assess the impact of DIRC1 on prognosis and the impact of DIRC1-related hub genes on prognosis. Gene oncology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were used to predict the function of differentially expressed genes associated with DIRC1. Gene set enrichment analysis (GSEA) was used to predict biological states or processes associated with DIRC1. Immune infiltration analysis was performed to identify the significantly involved functions of DIRC1. Protein–protein interaction (PPI) networks were established and 10 hub genes identified with Cytoscape software. Real time-polymerase chain reaction (RT-PCR) was used to detect the expression of DIRC1 in Gastric Cancer patients and healthy people. Increased DIRC1 expression in STAD was associated with T stage (P = .004), race (P = .045), histologic grade (P = .029) and anatomic neoplasm subdivision (P = .034). ROC curve suggested the significant diagnostic ability of DIRC1 (AUC = 0.779). High DIRC1 expression predicted a poorer Overall survival (P = .004, hazard ratio: 1.63; 95% confidence interval: 1.17‐2.27; P = .034). GO and KEGG analysis demonstrated that DIRC1 is related to epidermis, collagen-containing extracellular matrix, receptor-ligand activity, protein digestion and absorption, etc. GSEA demonstrated that E2F target, G2M checkpoint, Myc target, interferon γ reaction were differentially enriched in the high DIRC1 expression phenotype. SsGSEA and Spearman correlation revealed the relationships between DIRC1 and macrophages, dendritic cells, and Th1 cells were the strongest. Coregulatory proteins were included in the PPI network, higher expressions of 4 hub genes were associated with worse prognosis in STAD. RT-PCR showed that the expression of DIRC1 in the serum of Gastric Cancer patients was higher than healthy people (P = .027). DIRC1 expression was significantly correlated with poor survival and immune infiltrations in STAD, and it may be a promising prognostic biomarker in STAD.
Effect of stabilization exercise combined with respiratory resistance and whole body vibration on patients with lumbar instability: A randomized controlled trial
Authors: Park Sam-Ho , Oh Youn-Jung , Seo Jin-Hyuk , Lee Myung-Mo
Published: November 2022

Background:

Lumbar stability exercise promotes deep muscle functions, and it is an effective intervention method for increasing proprioceptive sensation. This study aims to explore and compare the effects of lumbar stability exercise with respiratory resistance and whole body vibration on patients with lumbar instability.

Methods:

This study is a 3-group randomized control trial. Through screening tests, 48 patients with lumbar instability were selected and randomly assigned to SE group (n = 16), stabilization exercise program using respiratory resistance (SER) group (n = 16), and stabilization exercise program using respiratory resistance and whole body vibration (SERW) group (n = 16). In order to compare the effects depending on the intervention methods, quadruple visual analogue scale (QVAS), Functional Ability Roland-Morris low back pain and disability questionnaire ([RMDQ], center of pressure path length, velocity, and area), Korean version of fear-avoidance beliefs questionnaire, and Pulmonary Function were used for measurement.

Results:

All of the groups showed significant improvements in QVAS, RMDQ, Korean version of fear-avoidance beliefs questionnaire, and balance abilities before and after the interventions. The SER group and SERW group showed a significant difference in QVAS and RMDQ than the SE group (P < .05). In addition, balance ability showed a significant difference in SERW group (P < .05), where only the SER group showed a significant difference in pulmonary function indexes including forced vital capacity, forced expiratory volume in 1 second, maximum inspiratory pressure, and maximum expiratory pressure (P < .05).

Conclusion:

Stabilization exercise program using respiratory resistance and whole-body vibration administered according to the purpose of intervention methods may be effective exercise programs for people with lumbar instability.
Medial maxillary (nasomaxillary buttress) fracture: Two case reports
Authors: Ogawa Masaru , Yokoo Satoshi , Nakamura Hidenori , Yamaguchi Takahiro , Suzuki Keisuke , Takayama Yu , Makiguchi Takaya
Published: November 2022

Rationale:

Medial maxillary fractures are defined as fractures of the medial aspect of the maxilla, that is, fractures of the nasomaxillary buttress. The diagnosis of medial maxillary (nasomaxillary buttress) fractures is challenging because of its similarities with nasal, and naso-orbito-ethmoidal (NOE) fractures.

Patient concern:

The patients included a 17-year-old Japanese man and a 37-year-old Japanese woman with facial injuries. Swelling of the affected cheek, nasal hemorrhage, periorbital ecchymosis, and C-shaped deviation of the nasal dorsum with normal nasal tip and root position were observed. Mild hypesthesia was noted in the affected region innervated by the left infraorbital nerve. Telecanthus, double vision, eye movement disorder, epiphora, trismus, tooth fracture, and malocclusion were absent in both cases.

Diagnosis:

Based on clinical signs and imaging findings, the patients were diagnosed with medial maxillary (nasomaxillary buttress) fracture.

Intervention:

The 17-year-old man underwent a reduction of the medial aspect of the maxillary bone with the treatment of concomitant fractures, and the 37-year-old woman did not request treatment.

Lessons:

Medial maxillary (nasomaxillary buttress) fractures are not included in any current classification of the maxillary fracture patterns. As medial maxillary (nasomaxillary buttress) fractures are similar to nasal, and NOE fractures, careful differential diagnosis is required before selecting the surgical procedure to be performed because the treatment of concomitant fractures is also necessary.
Progressive hemifacial atrophy in a Chinese patient: A case report
Authors: Li Rongrong , Yu Haiyan , Wang Xizi , Wang Weifei , Yan Lili , Guo Fangjie , Tian Conghui , Yuan Xiaoling , Zhao Min , Zheng Juan , Gu Mingliang , Jia Xiaodong , Gong Dianrong
Published: November 2022

Background:

Progressive hemifacial atrophy (PHA) is a rare and progressive condition of unknown etiology that is characterized by chronic progressive atrophy of the skin, subcutaneous tissue, muscle, and bone on 1 side of the face. However, its precise pathogenesis remains poorly understood.

Case presentation:

Here, we report a case of PHA, which manifested as left-sided facial atrophy. Whole-exome sequencing of peripheral blood samples from the patient and his parents, together with bioinformatics analyses, led to the identification of mutations inARHGAP4andCFAP47.

Conclusion:

This report is the first to describeARHGAP4andCFAP47mutations in a patient with PHA. These mutations may be related to the occurrence of hemifacial atrophy, although further studies are needed to clarify the role ofARHGAP4andCFAP47in the context of PHA pathogenesis.
TKIs combined with chemotherapy followed by allo-HSCT in Philadelphia chromosome-positive myelodysplastic syndrome: A case report and literature review
Authors: Qi Shasha , Wang Feiqing , Liu Yang , Zhao Jiangyuan , Wang Yan , Huang Songsong , Yang Wenxiu , Li Yanling , Shen Yong , Zhang Chike , Zhao Jianing , Yang Xu , Gao Rui , Chen Ying , Zhao Peng , Zhang Fengqi , Huang Yi , Zhao Mei , Wang Ping , Zhang Yan , Dou Hanbo , Wang Jishi , Li Yanju
Published: November 2022

Introduction:

Philadelphia chromosome (Ph) positive myelodysplastic syndrome (MDS) is a very rare disease. At present, the specific role of Ph in MDS is not clear, but such patients seem to have a poor prognosis, so the disease deserves attention. Here, we describe the history of a woman with Ph-positive MDS and perform a systematic review of related literature.

Patient concerns and diagnosis:

We report a 38-year-old woman with Ph-positive MDS.

Interventions and outcomes:

She received chemotherapy with decitabine, cytarabine, aclarubicin, and granulocyte colony-stimulating factor (DCAG) combined with imatinib mesylate and achieved a bone marrow remission. She then underwent an allogeneic hematopoietic stem cell transplant. The condition is good and no recurrence of the disease has been observed.

Conclusion:

Ph-positive MDS is a very rare disease. Ph may aid in the malignant progression of MDS leaving such patients with a very poor prognosis. Tyrosine kinase inhibitors (TKIs) plus chemotherapy followed by allogeneic hematopoietic stem cell transplantation has provided these patients with satisfactory outcomes.
Supplemental parenteral nutrition improves patient outcomes after esophageal cancer surgery: A single-center randomized controlled study
Authors: Xu Bindong , Chen Hao , Zhang Qiang , Chen Pengfei
Published: November 2022

Background:

We investigated the effect of supplemental parenteral nutrition comprising parenteral nutrition (PN) and enteral nutrition (EN) on the postoperative nutritional status, immune function, and inflammatory response of patients with esophageal cancer.

Methods:

Seventy-two patients with esophageal cancer were divided into the experimental group (PN + EN group; n = 36) and control group (total EN [TEN] group; n = 36). In the PN + EN group, EN and PN were administered on postoperative days 4 to 8. In the TEN group, EN was initiated on postoperative days 1 to 8. Changes in the nutritional status, immune function, and inflammatory indices were compared between groups.

Results:

Before surgery, the prealbumin (PA) values of both groups were lower than normal, and the C3, C4, and C-reactive protein (CRP) levels were above normal. The IgA, IgG, IgM, CD3, CD4, and CD4/CD8 levels were lower than normal, and the CD8 level was increased. On postoperative day 1, the PA levels of both groups decreased (P > .05), C3, C4, and CRP levels increased, and IgA, IgG, IgM, CD3, CD4, and CD4/CD8 decreased to values noted before surgery. On postoperative day 7, PA levels of the PN + EN group were significantly higher than those of the TEN group (P < .05). The CRP level of the PN + EN group was significantly lower than that of the TEN group (P < .05). IgA, IgG, and CD4 were significantly higher in the PN + EN group than in the TEN group (P < .05).

Conclusion:

Supplemental parenteral nutrition for perioperative esophageal cancer patients can maintain the optimal nutritional status, improve immune function, and reduce the inflammatory stress response.
Infectious diseases consultations from general internal medicine physicians in Japan: A descriptive single-center study
Authors: Hadano Yoshiro , Kosaka Shintaro , Tomoda Yoshitaka , Awaya Yukikazu , Kato Ryotaro
Published: November 2022

In Japan, general internal medicine (GIM) physicians must be aware of frequently encountered infections because of the shortage of infectious disease (ID) specialists. However, there are currently no epidemiological data on this subject. This study aimed to describe the frequency and pattern of ID consultations requested by GIM physicians in Japan. This is a 3-year retrospective review of the ID consultations requested by GIM physicians in Japan at a community-based acute tertiary care teaching hospital in Tokyo from April 2018 to March 2021. Demographic data, such as reasons for consultation, causative organism, and final diagnoses, were collected. During the study period, ID consultations were requested by GIM physicians 128 times. The incidence rates of bacteremia and 30-day mortality were 65.6% (n = 84) and 3.1% (n = 4), respectively. The most common diagnostic classifications after ID consultation were bone/joint (24.2%, n = 31), respiratory (17.7%, n = 22), and cardiovascular infections (12.5%, n = 16). The most common final diagnoses were bacteremia (11.7%, n = 15), infective endocarditis (9.4%, n = 12), and vertebral osteomyelitis (7.8%, n = 10). This is the first study to describe the ID consultation cases requested by GIM physicians in Japan in a community-based acute tertiary care teaching hospital. Despite the shortage of ID specialists, GIM physicians covered a wide range of IDs, including bone/joint infections and infectious endocarditis, which require long-term care. ID and GIM physicians, including hospitalists, should cooperate to promote the quality of care and clinical management. Future multi-center studies with large numbers of clinical cases are needed to determine the ID clinical knowledge required by GIM physicians in Japan.
Factors affecting the mental health of medical students during the COVID-19 pandemic: A cross-sectional study
Authors: Matsuo Moemi , Sesoko Sayaka , Kosa Ayumu , Noda Sakuya , Koura Seigo , Miyabara Hiroya , Higuchi Takashi
Published: November 2022

The coronavirus disease 2019 outbreak has impacted many educational institutions by imposing restrictions on offline or in-person lessons. Many students were stressed by “the loss of everyday life” due to the pandemic, and it is important to examine the impact of this loss on adolescents’ mental health. This study aimed to investigate the factors that affect students’ mental health during the pandemic from various perspectives. A total of 166 medical students participated in this study. Participants completed questionnaires about their demographics, life stress, mental health, and stress factors during in-person and online lecture days. Participants were divided into 2 groups, those with low and high mental health. The researchers compared independent variables between the groups using the χ
2 test or Fisher’s exact test. Multiple logistic regression analysis was performed, with mental health as the dependent variable. The multiple logistic regression analysis indicated that increased time spent online was significantly associated with mental health (P < .05). Human relations and the inability to meet/talk with friends trended toward a significant association with mental health (P < .1). The students who were not stressed about the increased time spent online were at a risk of low mental health. The students who appreciated interacting with others experienced more stress during the lockdown. To reduce students’ stress on online days, teachers should devise a lecture style with frequent breaks and introduce active learning. The findings of this study will contribute to addressing students’ low mental health and reducing their stress during the coronavirus disease 2019 pandemic.
Identification of CKS2 and RRM2 as potential markers of vitiligo using bioinformatics analysis
Authors: Miao Yu , Su Dongqiang , Fu Qian , Chen Taoyu , Ji Yanqi , Zhang Feng
Published: November 2022

Previous studies have attempted to elucidate the molecular mechanism of vitiligo; however, its pathogenesis remains unclear. This study aimed to explore biomarkers related to vitiligo through bioinformatic analysis. The microarray datasets GSE53146 and GSE65127 were downloaded from the Gene Expression Omnibus database. Firstly, differentially expressed genes (DEGs) in GSE53146 were screened, and then an enrichment analysis was performed. Secondly, the protein-protein interaction (PPI) network of DEGs was constructed using the STRING database, and the key genes were screened using the MCODE plugin in Cytoscape and verified using GSE65127. Finally, quantiseq was used to evaluate immune cell infiltration in vitiligo, then to observe the correlation between biomarkers and immune cells. In total, 544 DEGs were identified, including 342 upregulated and 202 downregulated genes. Gene Ontology (GO) enrichment showed that DEGs were related to inflammatory and immune responses, and Kyoto Encyclopedia of Genes and Genomes enrichment showed that DEGs were involved in many autoimmune diseases. In the PPI network, 7 key genes, CENPN, CKS2, PLK4, RRM2, TPX2, CCNA2, and CDC45 were identified by MCODE cluster and verified using the GSE65127 dataset. With an area under the curve (AUC) > 0.8 as the standard, 2 genes were screened, namely CKS2 and RRM2. Further immune infiltration analysis showed that M2 macrophages were involved in the pathogenesis of vitiligo, whereas CKS2 and RRM2 were both related to M2 macrophages. This study shows that CKS2 and RRM2 have potential as biomarkers of vitiligo and provides a theoretical basis for a better understanding of the pathogenesis of vitiligo.
Malignant transformation of oral potentially malignant disorders in Taiwanese indigenous peoples: A nationwide retrospective cohort study
Authors: Chen I-An , Chiu Sheng-Fu , Hung Kuo-Chuan , Yu Chia-Hung , Chen Yi-Chen , Ho Chung-Han , Chiang Wei-Fan , Chang Ying-Jen
Published: November 2022

Malignant transformation of oral potentially malignant disorders (OPMDs) is a potential cause of oral cancer. Currently, there is no research investigating the rate of malignant transformation of OPMDs into oral cancer in indigenous Taiwanese peoples. This study aimed to retrospectively investigate whether ethnicity (indigenous vs non-indigenous people) plays a role in increasing the malignant transformation rate of OPMDs into oral cancer. This study used data from the oral mucosal screening database and the Cancer Registry File, both of which originated from the National Health Insurance Research Database. We matched the baseline characteristics to control for confounding factors between indigenous peoples and non-indigenous peoples (17,768 indigenous subjects vs 71,072 non-indigenous subjects; 1:4 match) and compared the 2 cohorts. After matching for confounding factors such as age, sex, habits, and OPMD subtype, the malignant transformation rate was not statistically higher for indigenous people than for non-indigenous people. We also discovered that indigenous people with oral verrucous hyperplasia might have a higher chance of malignant transformation into oral cancer than the non-indigenous cohort. We conclude that ethnicity is not a risk factor for the malignant transformation of OPMDs into oral cancer; however, indigenous people with oral verrucous hyperplasia need to pay special attention and are suggested to undergo regular follow-ups for the occurrence of oral cancer.
Cognitive behavioral therapy for challenges to quitting tobacco smoking among social science and religion students
Authors: Nwosu Nneka C. , Ede Moses Onyemaechi , Onah Nkechi G. , Ekwueme Hope Uchechukwu , Obumse Nneka Anthonia , Amoke Chijioke V. , Chukwu Chinyere Loveth , Onah Sebastian O. , Amadi Kingsley , Ezurike Chukwuemeka A. , Oneli Joy Obiageli
Published: November 2022

Background:

Tobacco smoking is a public health issue. The aim of this investigation was to determine the effect of cognitive behavioral therapy (CBT) on the disputation of challenges to quitting tobacco smoking among students enrolled in the Social Science and religious Education programmes.

Methods:

The study adopted a pretest-posttest randomized controlled group design with follow-up. The population comprised of 76 tobacco smokers (randomized into 1 of 2 groups: n = 38 for the treatment group, n = 38 for the waitlist control group) completed the study. A self-report scale measuring dependence on cigarettes was used as the outcome measure. The treatment group was exposed to a 12-weeks CBT intervention. The treatment and waitlisted groups were evaluated at 3 time points: pretest, post-test, and follow-up. Statistical analyses were achieved using ANOVA.

Results:

The result showed that CBT had a significant effect in reducing the challenges to quitting tobacco smoking among the student smokers in the treatment group in comparison with the waitlist control group. The positive behavioral gains after the CBT program also persisted at follow-up in the treatment group compared with the waitlist control group.

Conclusion:

Therefore, this study suggests that CBT intervention is a time-effective treatment method for disputation of challenges to quitting tobacco smoking among students enrolled in the Social Science and Religious Education Programmes.
Impact assessment of a primary care physician counseling program for youth population
Authors: Kim Yun-Su , Kim Shin-Ae
Published: November 2022

This study aimed to investigate the impact of implementing a primary care physician (PCP) counseling program for the youth population with healthcare needs. This quasi-experimental study used a nonequivalent control group pretest-posttest design, and was conducted at Salim Health Innovation Clinic in Seoul between February and October 2019 comprising 46 participating youths (intervention group) and 48 nonparticipating youths (control group). After 6 months of implementation, drinking (alcohol use control) decreased significantly in the intervention group (0.84 points). There was a significant difference in the anxiety level with a decrease of 2.86 and 0.65 points in the intervention and control groups (P = .011) respectively. There was also a significant difference in the health responsibility domain (P = .04). Moreover, a significant difference in self-efficacy level was found with a mean increase of 0.18 and 0.16 points in the intervention and control groups (P = .001), respectively. The youth population is more prone to neglect self-care due to poor physical and mental health status and no hope for the future because of a lack of jobs and rising housing prices. The program reinforces health-promoting behavior for managing stress and practicing eating high-quality meals, regular exercise, and regular health screening, which can help implement continuous and effective healthcare.
Partial sleep restriction-induced changes in stress, quality of life, and lipid metabolism in relation to cold hypersensitivity: A before-and-after intervention study
Authors: Baek Younghwa , Jung Kyoungsik , Kim Hoseok , Lee Siwoo
Published: November 2022

Sleep disturbances are associated with cold hypersensitivity (CH) and characterized by excessive cold sensation in specific body parts and cold thermal discomfort. This study investigated the effects of short-term sleep restriction followed by a recovery phase on subjective health status, inflammation, and lipid metabolism in different types of CH. A total of 118 healthy adults aged 35 to 44 years without sleep disturbances were enrolled. Participants underwent 4-hour sleep restrictions per day for 3 days at a hospital and then returned to their daily lives for 4 days of rest. CH was assessed using a structured questionnaire with eight characteristic symptoms. A questionnaire and blood tests were administered baseline, after sleep restriction, and follow-up to assess cortisol, lipid profiles, and self-reported stress and quality of life (QOL). Participants were divided into CH (44.1%) and non-CH (55.9%) groups. The CH group showed increased stress, impaired QOL, and decreased low-density lipoprotein-cholesterol (LDL-C) levels compared to the non-CH group after sleep restriction. The variance for QOL (effect size = 0.07), subjective stress (effect size = 0.053), and LDL-C (effect size = 0.029) among time points depended on the group. Short-term sleep restriction was associated with deterioration of subjective health and reduced lipid metabolism; such changes were more evident in the CH group. Our findings suggest the need to consider an individual’s CH status to assess the clinical risk associated with insufficient sleep.
Risk factors for stroke in a population of central China: A cross-sectional study
Authors: Wang Honglian , Wu Mingcan , Tu Qingfen , Li Maokun
Published: November 2022

The incidence and mortality rates of stroke in China are higher than the world average, seriously endangering the public’s health and quality of life. It is important to predict the incidence of stroke, identify the high-risk factors in the region, and raise the risk awareness of high-risk groups. This study sought to investigate and analyze the distribution of stroke population and the main risk factors for stroke occurrence in a Chinese population, and to predict the probability of stroke occurrence in high-risk groups with risk factors, so as to provide a scientific basis for the comprehensive prevention and treatment of stroke. A whole-group sampling method was used to investigate 1009 participants in Jingzhou city in central China, and a uniform questionnaire survey and related medical examinations were conducted. The risk factors for stroke in the area were analyzed by univariate analysis, and a multifactorial logistic regression prediction model was established based on the results of univariate analysis. The results of univariate and multifactorial logistic regression analyses suggested that gender, age, family history of stroke, hypertension, atrial fibrillation, diabetes, and sedentary lifestyle were significantly associated with an increased risk of stroke in the local population (all P < .05). The top 5 risk factors for stroke were atrial fibrillation (odds ratio [OR] = 5.225, 95% confidence interval [CI]: 2.826–9.663), sedentary lifestyle (OR = 2.701, 95% CI: 1.667–4.376), age (≥65 years) (OR = 2.593, 95% CI: 1.680–4.004), hypertension (OR = 2.106, 95% CI: 1.380–3.216), and gender (male) (OR = 2.099, 95% CI: 1.270–3.471). This study effectively identifies the high risk factors for stroke and provides scientific insights for risk assessment, intervention of risk factors, and decision making of health management departments in the central region of China. The modifable risk factors for stroke such as smoking, hypertension, atrial fibrillation, diabetes mellitus, and sedentary lifestyle were also observed. Our findings further highlight the significant of the primary and secondary prevention for stroke and reveal the potential targets to reduce the heavy stroke burden in China around the world.
Resolved hepatitis B infection in patients receiving immunosuppressive therapy: Monitor versus prophylaxis against viral reactivation
Authors: Elsebaey Mohamed A. , Elbedewy Tamer A. , Elashry Heba , Elrefaey Waleed , Elshweikh Samah A. , Elhadidy Ahmed A. , Shalaby Neveen A. , Elsokkary Assem Mohamed , Elashtokhy Hossam Eldin A. , Abo-Amer Yousry Esam-Eldin , Abo-Elfetoh Ashraf Rafat , Hassanien Sharaf Elsayed Ali , Fouad Amina , Abdellatif Raghda Samir , Ismail Amro Abdelaziz Mohammed
Published: November 2022

Risk of hepatitis B virus reactivation (HBVr) in patients with resolved HBV infection receiving immunosuppressive therapy has been a growing concern, particularly in the era of biological and targeted therapies. HBV monitoring versus antiviral prophylaxis against HBVr in those patients remains controversial. The aim of the study was to determine the incidence of HBVr and HBV-related hepatitis in resolved HBV patients who received immunosuppressive therapy with or without antiviral prophylaxis. This retrospective study included 64 patients with resolved HBV infection who received different regimens of immunosuppressive medications, with moderate risk of HBVr, for variable underlying diseases. Patients who had chronic HBV infection or other viral infections were excluded. Patients who received B-cell depleting therapies were ruled out. They were divided into 2 groups: group 1 included 31 patients who received immunosuppressive therapy without antiviral prophylaxis, and group 2 included 33 patients who received antiviral prophylaxis (entecavir) within 2 weeks of commencing the immunosuppressive therapy. HBVr, HBV-related hepatitis, and HBV-unrelated hepatitis were assessed along a 1-year duration. The overall HBVr incidence was 1.56% (1/64). This patient who had HBVr was seen in group 1. There were no significant differences between the 2 groups regarding the incidence of HBVr, HBV-related hepatitis, HBV-unrelated hepatitis, and immunosuppressive therapy interruption along a 1-year duration. Based on this retrospective study, close monitoring was equal to antiviral prophylaxis regarding the outcome of resolved HBV patients who received moderate risk immunosuppressive therapy. HBV treatment should commence once HBVr is confirmed.
Exploring the mechanism of Epimedii folium and notoginseng radix against vascular dementia based on network pharmacology and molecular docking analysis: pharmacological mechanisms of EH-PN for VD
Authors: Tong Tianhao , Cheng Bin , Tie Songyan , Zhan Gangxiang , Ouyang Dan , Cao Jianzhong
Published: November 2022

To explore the mechanism of Epimedii Folium (HF) and Notoginseng Radix (NR) intervention in vascular dementia (VD). This study used the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database to collect the active ingredients and potential drug targets of HF and NR, the Uniprot database to convert drug target names into gene names, GeneCards, Drugbank, Therapeutic Target Database, and Online Mendelian Inheritance in Man database to collect the potential disease targets of VD, and then combined them with the drug targets to construct the HF-NR-VD protein-protein interaction (PPI) network by Search Tool for the Retrieval of Interacting (STRING). Cytoscape (version 3.7.1) was used to perform cluster analysis of the PPI network. Metascape database was used for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The potential interaction of the main components of the HF-NR couplet medicine with core disease targets was revealed by molecular docking simulations. There were 23 predicted active ingredients in HF and NR, and 109 common drug targets that may be involved in the treatment of VD. Through PPI network analysis, 30 proteins were identified as core proteins owing to their topological importance. GO functional analysis revealed that the primary biological processes were mainly related to inflammation, apoptosis, and the response to oxidative stress. KEGG pathway enrichment analysis revealed that TNF and PI3K/Akt signaling pathways may occupy the core status in the anti-VD system. Molecular docking results confirmed that the core targets of VD had a high affinity for the main compounds of the HF-NR couplet medicine. We demonstrated the multi-component, multi-target, and multi-pathway characteristics of HF-NR couplet medicine for the treatment of VD and provided a foundation for further clinical application and experimental research.
Iliopsoas hematoma secondary to small needle scalpel for the treatment of nonspecific low back pain: A case report
Authors: Zeng Wu , Zhou XiaoMing , Zhu JunFeng , Li Jun , Weng YongYong
Published: November 2022

Introduction:

Nonspecific low back pain (NSLBP) is one of the most common symptoms which can happen all ages and it accounts for the majority of low back pain (LBP). Current clinical studies have shown that rest, physical therapy, acupuncture (including small needle scalpel) and non-steroidal antiinflammatory drugs are effective treatments for NSLBP. However, the safety of small needle scalpel for treatment of NSLBP was reported rarely.

Patient concerns:

A 63-year-old female patient was referred to the emergency department for right lower back pain, right lower quadrant ache, weakness of flexion right hip joints and worsening pain with walking after the treatment of small needle scalpel, which was performed by a rural doctor; the symptoms had been lasting for 9 hours.

Diagnosis:

She was diagnosed with traumatic iliopsoas hematoma because she experienced increased back pain after accepting small needle scalpel. Clopidogrel was stopped and the patient did not received a blood transfusion and just monitored Blood routine examination, liver and function, coagulation function after admission.

Interventions:

She had rest in bed absolutely for 3 days after admission. On the fourth day, she restarted taking Clopidogrel 75 mg every day and has gradually increased time for ambulation. She was discharged home and was ambulating with the help of a walking frame on day 7 and her follow-up abdominal CT scan on day 11 revealed reduced slightly hematoma. She was treated with rest, and showed an gradual recovery in approximately 3 weeks.

Outcomes:

At day 85, the patient’s LBP symptoms had completely disappeared and the result of liver function, renal function, coagulation function, blood routine was normal.

Conclusion:

Small needle scalpel is a form of acupuncture. In China, small needle scalpel therapy has been used to treat various kinds of chronic pain. Anticoagulation therapy is a risk for bleeding, and patients who used Clopidogrel prepare to adopting small needle scalpel needs to be very cautious.