bluuebunny/crossref_metadata_2025 huggingface dataset:
A Structural Description of Biases That Generate Immortal Time
Authors: Hernán Miguel A. , Sterne Jonathan A. C. , Higgins Julian P. T. , Shrier Ian , Hernández-Díaz Sonia
Published: November 2024

Immortal time may arise in survival analyses when individuals are assigned to treatment strategies based on post-eligibility information or selected based on post-assignment eligibility criteria. Selection based on eligibility criteria applied after treatment assignment results in immortal time when the analysis starts the follow-up at assignment. Misclassification of assignment to treatment strategies based on treatment received after eligibility results in immortal time when the treatment strategies are not distinguishable at the start of follow-up. Target trial emulation prevents the introduction of immortal time by explicitly specifying eligibility and assignment to the treatment strategies, and by synchronizing them at the start of follow-up. We summarize analytic approaches that prevent immortal time when longitudinal data are available to emulate the target trial from the time of treatment assignment. The term “immortal time bias” suggests that the source of the bias is the immortal time, but it is selection or misclassification that generates the immortal time, leading to bias.
Self-management interventions to patients with cirrhosis: A scoping review
Authors: Aden Samsam , Lauridsen Mette Munk , Grønkjær Lea Ladegaard
Published: November 2024

Background:

Self-management in chronic diseases like cirrhosis involves patients providing the necessary knowledge, skills, and confidence to enhance self-efficacy. This scoping review aims to describe the literature on self-management interventions in patients with cirrhosis to create an overview and identify key concepts and gaps in the existing literature.

Methods:

Four databases (CINAHL, Embase, Medline, and Scopus) were searched from November 2022 to September 2024. The review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. Studies published from 2000 onward, including patients with cirrhosis of different etiology and severity, focusing on self-management and/or self-efficacy, and performed in a health care setting, were considered.

Results:

The search produced 1012 articles, of which 16 were included in the review. These represented studies from 7 countries and a sample of 1.276 patients. The studies differed in study design, sample size, delivery format, self-management interventions designed by the authors, and evaluation. However, all studies described some form of improvement in patient-related and clinical outcomes after the intervention, mainly improved patient knowledge and quality of life.

Conclusions:

Self-management interventions for patients with cirrhosis improved patient-related outcomes. However, more comprehensive and standardized interventions tailored to patients’ needs are needed. These self-management interventions should focus on increasing confidence and self-efficacy and address the different skills required by patients to manage their disease.
An Online Training Program Was Effective on Improving Physical Performance and Body Composition in U20 Soccer Players During the COVID-19 Quarantine
Authors: Veeck Filipe , Grazioli Rafael , Oliveira Gabriel S. , Baroni Bruno M. , Cadore Eduardo Lusa , Pinto Ronei Silveira
Published: November 2024

It is recommended for athletes keep training to reduce the negative effects of detraining. This study aimed to verify the effects of a 15-week online training intervention during a pandemic quarantine in body composition and physical capacity of highly trained soccer players. Sixteen male under-20 soccer players were assessed after the first period of COVID-19 quarantine (March 2020 to September 2020; 170 days), and after the second period of COVID-19 quarantine (November 2020 to February 2021, 107 days). Body composition, vertical jump height, hamstring maximum strength and aerobic capacity were assessed. The online training program was performed during the second lockdown. In comparison with first pre assessments, results showed that fat mass (−0.95 ± 1.27), free fat mass (1.22 ± 1.19), squat jump height (5.36 ± 1.99) and counter movement jump (3.19 ± 3.77) were significantly improved (P < 0.05). However, there were no significant changes in total body mass, hamstring eccentric strength, and Yo-Yo IR1 after online training (P > 0.05). In summary, the findings of this study highlight the importance of carrying out a training program during a period of absence from traditional soccer training, in order to maintain the level of physical capacities of youth soccer players.
The Impact of Visual Distraction Interventions on Patients’ Pain and Anxiety During Colonoscopy
Authors: Saab Omar , Al-Obaidi Hasan , Merza Nooraldin , Bhagat Umesh , Al-Sagban Alhareth , Algodi Marwah , Abuelazm Mohamed , El-Serag Hashem
Published: November 2024

Background and Objective:

Patients undergoing colonoscopy may experience psychological distress related to the procedure, which may deter adherence and acceptance of future colonoscopies. Visual/audiovisual distraction interventions to alleviate colonoscopy-related pain and anxiety have been developed. This study aims to investigate the impact of these interventions on colonoscopy-related outcomes.

Methods:

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) testing the efficacy of visual/audiovisual distraction. Eligible studies were systematically retrieved by searching PubMed, EMBASE, WOS, SCOPUS, and Cochrane through June 2024 and extracted by 2 investigators. Continuous and dichotomous outcome variables were pooled using Cohen’s d and risk ratio (RR) with confidence interval (CI) using Stata MP version 17. We assessed heterogeneity using the χ2 test and I
2 statistic (PROSPERO ID: CRD42024555902).

Results:

We included 13 RCTs with 1439 patients randomized to an active intervention (n=804) or usual care (n=635). Only 3 RCTs were endoscopists-blinded studies, whereas the rest were open-label. The interventions included playing nature scene videos, real-time videos of the colonoscopy, or movies preferred by the patients. The active intervention arm was associated with a significant reduction in the pain experienced during colonoscopy (Cohen’s d: −0.57, 95% CI [−0.79, −0.35], P<0.0001), reduced anxiety related to colonoscopy (Cohen’s d: −0.66, 95% CI [−1.15, −0.18], P=0.01), and increased patients’ satisfaction (Cohen’s d: 0.65, 95% CI [0.49, 0.80], P<0.0001) compared with patients who received the usual care during colonoscopy. There were no significant differences between both groups in the willingness to re-undergo the procedure (RR: 1.11, 95% CI [0.98, 1.25], P=0.09), analgesia use (Cohen’s d: −0.21, 95% CI [−0.42, 0.0], P=0.05), or total procedure duration (Cohen’s d: −0.12, 95% CI [−0.24, 0.0], P=0.06).

Conclusions:

Visual/audiovisual distraction interventions decrease colonoscopy-associated pain and anxiety and increase patients’ satisfaction. These are promising interventions to improve patient compliance and quality of care during colonoscopy.
Brain Fog in Gastrointestinal Disorders
Authors: El Halabi Maan , Arwani Remy , Rao Satish C. , Parkman Henry P.
Published: November 2024

Introduction:

Brain fog (BF) is a term used to describe difficulties with concentration, memory, and overall mental clarity. Links of BF to chronic fatigue syndrome and COVID-19 have been described, as well as recently to small intestinal bacterial overgrowth (SIBO) and probiotics.

Aim:

To investigate the association between BF, SIBO, intestinal methanogen overgrowth (IMO), gastrointestinal (GI) medications, and specific GI disorders [irritable bowel syndrome (IBS) and gastroparesis] by utilizing a questionnaire to help diagnose BF.

Methods:

Patients undergoing lactulose breath testing (LBT) for clinical assessment of SIBO filled out a demographic questionnaire, including an inquiry about the presence of BF, a symptom questionnaire (PAGI-SYM), and a BF Questionnaire (BFQ; 20 BF symptoms rated never=0 to always=4, total score 0 to 80).

Results:

A total of 102 patients underwent LBT, with the most common indication being bloating (67%), of whom 55 (54%) reported BF. The BFQ score was significantly higher in patients reporting BF than those not [38.2±15.6 vs. 10.9±9.4 (SEM) (P=0.001)]. Patients with BF were more likely to be on probiotics and proton pump inhibitors compared with those without BF (P=0.04). There was no major difference in the use of narcotics, prokinetics, or prebiotics. Gastroparesis and IBS were more common in patients who reported BF (P=0.01 and 0.05, respectively), but not SIBO or IMO by breath testing.

Conclusions:

BF was observed in over one-half of patients with common GI disorders. The prevalence of BF was higher in patients on probiotics and those with gastroparesis and IBS. The BFQ may be useful to diagnose and quantify BF severity.
Exploration and identification of diabetes targets in nursing: CDH1 and DVL1
Authors: Cheng Fei , Li Lixia , Zhang Yanting
Published: November 2024

Diabetes is a chronic disease caused by absolute or relative insufficiency of insulin secretion and impaired insulin utilization. CDH1 and DVL1 role in diabetes and its nursing care is unclear. The diabetes dataset GSE21321 and GSE19790 profiles were downloaded from the gene expression omnibus (GEO) database. Perform differentially expressed genes (DEGs) screening, weighted gene co-expression network analysis (WGCNA), protein-protein interaction (PPI) network construction and analysis, functional enrichment analysis, gene set enrichment analysis (GSEA), immune infiltration analysis, and Comparative Toxicogenomics Database (CTD) analysis. Gene expression heat map was drawn. TargetScan was used to screen the miRNA that regulates central DEGs. 1983 DEGs were obtained. According to Gene Ontology (GO) analysis, they were mainly enriched in signal regulation, catenin complexes, and signal receptor binding. In Kyoto Encyclopedia of Gene and Genome (KEGG) analysis, they were mainly concentrated in the Rap1 signaling pathway, cAMP signaling pathway, and Hippo signaling pathway. The DEGs are mainly enriched in cell signaling, Wnt signaling vesicles, growth factor activity, and the interaction between neural active ligands and receptors. In the enrichment project of Metascape, BMP signaling pathways and cell population proliferation can be seen in the GO enrichment project. The soft threshold power in WGCNA is set to 5. A total of 15 modules were generated. Core gene expression heatmap showed that core genes (CTNNB1, CDH1, DVL1) were highly expressed in diabetes samples. CTD analysis showed thatCTNNB1, CDH1, DVL1were associated with weight gain, inflammation, and necrosis. CDH1 and DVL1 are highly expressed in diabetes and may become molecular targets for diabetes and its care.
Exploring female fitness app users’ motivations and perceptions: A qualitative study
Authors: Lyu Le , Abidin Nor Eeza Zainal , Zulnaidi Hutkemri
Published: November 2024

Background:

Women make up nearly 60% of fitness App users and play an important role in the operation and development of these Apps. Despite the widespread adoption of fitness Apps in recent years due to their many physical and mental benefits, the use of Apps tends to be short-term, and user engagement is relatively low. Little is known about the factors that motivate female users to consistently use fitness Apps. This study aimed to study attributes of fitness Apps that are most likely to influence female users during their use of Apps.

Methods:

The means-ends chain theory and the soft-laddering interview technique were used to analyze the attributes that influenced females’ perceptions of fitness apps, focusing on the features most likely to provide them with benefits and value.

Result:

The results of the study indicated that instructiveness, interaction, personalization, ease of use, and convenience were the most important attributes valued by female fitness App users; peer support, entertainment, and exercise adherence were the most important consequences; and health, self-fulfillment, enjoyment of life and sense of achievement were the most important values.

Conclusion:

The findings provide researchers and management of fitness Apps and women’s sports with valuable insights from the means-ends chain theory, as well as suggestions for applying App design and promotion.
Effect of theta burst stimulation on lower extremity motor function improvement and balance recovery in patients with stroke: A systematic review and meta-analysis of randomized controlled trials
Authors: Chen Kang , Sun Meixia , Zhuang He
Published: November 2024

Background:

To investigate the therapeutic benefits of theta burst stimulation on lower-limb motor dysfunction and balance recovery in patients with stroke.

Methods:

A literature search was performed across CNKI, CBM, WanFang, VIP, PubMed, Embase, Cochrane Library, and Web of Science until November 2023. The Methodological quality of included studies was assessed by using the Cochrane risk-of-bias tool and the PEDro scale, and the meta-analysis was performed by using RevMan 5.3 software. Two independent researchers screened the literature and extracted basic information on participants, interventions, comparisons, outcomes, and studies.

Results:

Eight studies, including cTBS and iTBS, with 290 participants meeting the inclusion criteria for this systematic review, and 7 studies including only iTBS with 230 participants were included in this meta-analysis. The methodological quality of the studies included ranged from moderate to high. The results showed iTBS had significantly higher scores on the Berg Balance Scale (BBS) than the control group. (MD = 4.57, 95% CI: 1.76 to 7.38, Z = 3.19, P = .001). Subgroup analysis showed CRB-iTBS markedly improved BBS scores (MD = 4.52, 95% CI: 1.78 to 7.27, Z = 3.23, P = .001), whereas LE M1-iTBS did not exhibit a significant enhancement in BBS scores (MD = 6.10, 95% CI: −7.34 to 19.53, Z = 0.89, P = .37); iTBS showed no significant increase in lower-limb motor function (FMA-LE) (MD = 1.80, 95% CI: −1.10 to 4.69, Z = 1.22, P = .22). Subgroup analysis revealed both CRB-iTBS and LE M1-iTBS interventions were not effective in improving FMA-LE (MD = 3.15, 95% CI: −4.70 to 11.00, Z = .79, P = .43; MD = 1.05, 95% CI: −2.20 to 4.30, Z = .63, P = .53); iTBS significantly reduced the MEP latency (P = .004), but did not show a significant improvement in walking performance (10 MWT), mobility (TUG), or activities of daily living [M(BI)] (P > .05).

Conclusion:

Based the current study, iTBS can increase patients’ balance function. The CRB-iTBS protocol is more effective than the LE M1-iTBS protocol. Additionally, iTBS may be a promising therapy tending to enhance lower-limb motor function, walking performance, mobility, and activities of daily living.
Construction of a prognostic model based on cuproptosis-related patterns for predicting survival, immune infiltration, and immunotherapy efficacy in breast cancer: Cuproptosis-based prognostic modeling in breast cancer
Authors: Tang Yuanyuan , Lv Chunliu , Luo Zhenhua , Li Zan , Yu Junyi
Published: November 2024

Breast cancer is the most common and lethal malignancy among women worldwide. Cuproptosis, a newly identified copper-dependent cell death, is closely associated with cancer development. However, its regulatory mechanisms in breast cancer are not well studied. This study aims to establish a prognostic model for breast cancer to improve risk stratification. The mRNA expression data was downloaded from The Cancer Genome Atlas and Gene Expression Omnibus databases. Consensus clustering identified patterns based on cuproptosis-related genes. Key genes were screened using Weighted Gene Co-Expression Network Analysis and differentially expressed gene analysis. A prognostic model was constructed using Cox regression and evaluated with time-dependent receiver operating characteristic and Kaplan–Meier analyses. Functional pathways, immune cell infiltration, and other tumor characteristics were also analyzed. Two distinct cuproptosis patterns were identified. The top 21 differentially expressed genes, significantly associated with survival, were used to construct the prognostic model. The risk score has a negative correlation with survival. Enrichment analysis showed immune-related pathways enriched in the low-risk group, which also had more immune cell infiltration, higher stromal component, lower tumor purity, and lower tumor heterogeneity. Finally, significant differences of half maximal inhibitory concentration were also observed between patients in high- and low-risk groups who received chemotherapy and targeted therapy drugs. These findings in our study may provide evidence for further research and individualized management of breast cancer.
Efficacy and mechanism of Tiaoshu Anshen Decoction in treating insomnia with spleen and stomach Qi dysfunction: A retrospective study
Authors: Zhou Fang , Du Lei , Yu Liping , Zhang Dong , Jin Haitao , Li Zhijie
Published: November 2024

This study investigates the clinical efficacy of Tiaoshu Anshen Decoction in treating insomnia characterized by spleen and stomach Qi dysfunction. According to the differences of previous treatment, 94 patients were divided into treatment group and control group. The treatment group was treated with Tiaoshu Anshen Decoction, and the control group was treated with oral esazolam for 2 weeks. We compared serum levels of 5-hydroxyindoleacetic acid (5-HIAA), 5-hydroxytryptamine (5-HT), norepinephrine (NE), dopamine (DA), DASS-21, and HAMD scores before and after treatment. We also evaluated gastrointestinal function, traditional Chinese medicine syndrome scores, quality of life, and adverse reactions, with statistical analysis conducted using SPSS 25.0. The overall efficacy and clinical outcomes were comparable between the 2 groups. Both groups showed increased serum factor levels and decreased Pittsburgh Sleep Quality Index (PSQI), HAMD, and DASS-21 scores post-treatment. Notably, the treatment group exhibited significant improvement in stool consistency, digestive symptoms, DOB < 4 and DOB ≥ 4 distribution, and TCM syndrome scores, outperforming the control group. No adverse reactions were reported in either group. This study suggests that spleen and stomach Qi dysfunction significantly contribute to insomnia, affecting its occurrence, type, and severity. Tiaoshu Anshen Decoction effectively enhances 5-HIAA, 5-HT, NE, and DA levels, reduces inflammatory factors, and improves sleep quality, gastrointestinal function, and overall quality of life. The decoction may exert its effects by regulating Qi dynamics and gastrointestinal function, indicating the gastrointestinal system as a potential key target in treating sleep disorders.
Neutrophil-to-lymphocyte ratio predicts poor prognosis in patients with chronic kidney disease–related pulmonary hypertension: A retrospective study
Authors: Ge Huipeng , Zhang Linlin , Zhang Weiwei , Yuan Qiongjing , Xiao Xiangcheng
Published: November 2024

Inflammation plays a crucial role in chronic kidney disease (CKD) and pulmonary hypertension (PH). Considering that the neutrophil-to-lymphocyte ratio (NLR) has recently emerged as a powerful predictor of adverse outcomes in many chronic diseases, we aimed to investigate the association between NLR and all-cause mortality in patients with CKD-related PH. A total of 176 hospitalized patients with predialysis CKD-related PH were recruited retrospectively from January 2012 to June 2020 by reviewing electronic medical records. The NLR and clinical characteristics of the patients were included in the current analysis. The Kaplan–Meier method and univariate and multivariate Cox regression analyses were performed to identify the association between NLR and the incidence of all-cause mortality. Baseline NLR values were associated with hemoglobin, estimated glomerular filtration rate and C-reactive protein. During a median follow-up period of 32.5 (11.3–53.0) months, 23 patients died. Regardless of whether the NLR acted as a continuous variable with a hazard ratio of 1.408 (95% confidence interval: 1.124–1.763) or a categorical variable (NLR ≤4.3 vs NLR >4.3) with a hazard ratio of 3.100 (95% confidence interval: 1.299–7.402), an elevated NLR was significantly associated with all-cause mortality in different models. A greater NLR at baseline was remarkably associated with a higher all-cause mortality in hospitalized patients with CKD-related PH.
Efficacy and safety of edaravone combined with Ginkgo Leaf Extract and Dipyridamole in the treatment of acute cerebral infarction: A systematic review and meta-analysis
Authors: Lyu Yangting , Xu Bin
Published: November 2024

Background:

To evaluate the clinical efficacy and safety of edaravone combined with Ginkgo Leaf Extract and Dipyridamole (GLED) versus edaravone alone in the treatment of acute cerebral infarction (ACI) by the method of meta-analysis.

Methods:

PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, WANFANG DATA, and Chinese Scientific Journal Database were searched to identify publications on edaravone combined with GLED for ACI from inception to June 20, 2024. Stata15.0 statistical software was applied for data analysis. The test group was treated with edaravone combined with GLED, while the control group received edaravone alone.

Results:

A total of 12 records were involved in this meta-analysis. The combined results exhibited that the effective rate of edaravone combined with GLED was significantly higher than that of edaravone in the treatment of ACI (relative risk = 1.21, 95% confidence interval [CI] = 1.15–1.27, P < .001). The National Institute of Health stroke scale scores of edaravone combined with GLED were significantly lower than those of edaravone alone in the treatment of ACI (standardized mean difference = −1.93, 95% CI = −3.36 to −0.50, P = .008). The incidence of adverse reactions in the edaravone combined with GLED group was significantly lower than that in the edaravone alone group (relative risk = 0.48, 95% CI = 0.33–0.70, P < .001) in the treatment of ACI.

Conclusion:

The combination of edaravone with GLED for treating ACI has better efficacy and higher safety than edaravone alone. Given the limited number of studies identified and possibility of publication bias, the above findings should be verified by more high-quality trials in the future.
Prediction of cardiac deterioration in acute heart failure patients: Evaluation of the efficacy of single laboratory indicator models versus comprehensive models
Authors: Yang Xiaoyu , Wen Liang , Sun Min , Yang Junlu , Zhang Bin
Published: November 2024

This study aims to compare the efficacy of single-indicator models versus comprehensive models in predicting cardiac deterioration events in patients with acute heart failure (AHF), providing a more precise predictive tool for clinical practice. This retrospective cohort study included 484 patients with AHF treated at our hospital between June 2018 and January 2023. Patients were categorized into a deterioration group and a non-deterioration group based on the occurrence of cardiac deterioration events within 1 year, defined as cardiogenic shock, cardiac arrest, or the need for mechanical circulatory support. We collected clinical data, laboratory markers, and imaging indicators for analysis. Both single-indicator models and comprehensive models (clinical data + indicators) were constructed and evaluated using the area under the receiver operating characteristic (ROC) curve (AUC) to assess their predictive performance. Among the 484 AHF patients, 121 were in the deterioration group and 363 were in the non-deterioration group. Among the single indicators, WBC had the highest AUC of 0.683. The indicator model (WBC, NOMO, Cr, BUN, Troponin, NT-proBNP, D-Dimer, LVEF, and RVFAC) achieved an AUC of 0.886 in the training set and 0.876 in the validation set. The comprehensive model (age, time from onset to admission, heart failure type, WBC, NOMO, Cr, BUN, troponin, NT-proBNP, LA, D-dimer, fibrinogen, and RVFAC) had an AUC of 0.940 in the training set and 0.925 in the validation set. In the training set, the comprehensive model had a significantly higher AUC than the indicator model (P < .05), while no significant difference was observed between the 2 in the validation set (P > .05). Furthermore, decision curve analysis (DCA) and calibration curve analysis indicated that the comprehensive model provided greater clinical benefits and better predictive accuracy in clinical applications. The comprehensive model demonstrates superior predictive capability for cardiac deterioration events in AHF patients, significantly outperforming both single-indicator and indicator models. This suggests that a comprehensive assessment can more accurately identify high-risk patients, offering a more reliable basis for clinical decision-making.
Gastroesophageal reflux disease, mood swings, and frozen shoulder: A two-sample, two-step Mendelian randomization study
Authors: Guo Qiu-Cheng , Cai He , Hong Wu , Chen Yin-Ying , Lu Qing , Zheng Shu-Guang
Published: November 2024

A Mendelian randomization (MR) study was undertaken to establish a causal link between gastroesophageal reflux disease (GERD) and frozen shoulder (FS), examining whether the risk of GERD with FS is mediated through mood fluctuations. Genetic loci from populations of independent European ancestry were selected as instrumental variables for GERD, FS, and mood swings. The primary analysis employed the inverse-variance weighted method supplemented by 3 additional analytical methods. This was conducted using two-sample and two-step MR analyses. This study explored the correlation and mediating effects of mood swings between GERD and FS. Our study employed heterogeneity and horizontal diversity, and sensitivity analysis was conducted using the leave-one-out method to explore the robustness of the results. In the two-sample MR analysis, for every 1-unit increase in the log-transformed odds ratio (OR) of GERD, the corresponding OR increased to 1.844 (inverse-variance weighting: OR = 1.844, 95% confidence interval: 1.47–2.30, P < .001). In the two-step MR analysis, we found that mood swings played a mediating role in the association between GERD and FS. We assessed this mediating effect using the delta method (b = 0.181, SE = 0.059, OR = 1.199, 95% confidence interval: 1.072–1.349). Analysis of the data using the above methods indicated that GERD is a risk factor for FS, and mood swings mediate between the 2. Therefore, GERD and mood swings should be included in the health management of patients with FS.
Effects of cognitive training on cognitive function in patients after cardiac surgery: A systematic review and meta-analysis of randomized controlled trials
Authors: Zhang Rongxiang , Zhu Chenyang , Chen Shiqi , Tian Feng , Huang Pingping , Chen Yuan
Published: November 2024

Background:

Postoperative cognitive deficits frequently occur in patients undergoing cardiac surgery, leaving them with reduced cognitive function. Cognitive training has been shown to improve cognitive function, however, the role in patients after cardiac surgery is unclear. In this study, we aimed to evaluate the effectiveness and safety of cognitive training in patients undergoing cardiac surgery.

Method:

A systematic search of PubMed, Embase, Cochrane Library, CINAHL, Ovid Medline, Web of Science, CNKI, and Wanfang was conducted until March 2024. The risk of bias was assessed using the Cochrane Risk of Bias Tool. Data were meta-analyzed using RevMan 5.4 software. Potential bias and reliability of evidence were fairly assessed by using the Cochrane risk of bias method and the GRADE evidence grading method.

Results:

A total of 16 studies involving 1335 cardiac surgery patients were included in this study. Compared with the control group, the cognitive training group had a significantly lower incidence of postoperative cognitive dysfunction (RR 0.35, 95% CI 0.18–0.65, P = .001), significantly improved cognitive function (MD 2.54, 95% CI 1.27–3.81, P < .001), and a significantly higher quality of life-mental component (MD 5.22, 95% CI 2.32–8.13, P < .001), anxiety (MD −6.05, 95% CI −10.96 to −1.15, P = .02) and depression (MD −3.97, 95% CI −7.15 to −0.80, P = .01) were significantly improved between groups. However, the differences were not statistically significant for postoperative delirium (RR 1, 95% CI 0.38–2.65, P = 1.00) and postoperative hospitalization (MD −0.95, 95% CI −2.90 to 1.00, P = .34).

Conclusions:

The present study, based on a low to moderate quality of evidence, suggests that cognitive training improves cognitive functioning, reduces the incidence of postoperative cognitive dysfunction, and has a positive impact on anxiety and depression in patients undergoing cardiac surgery. However, current evidence does not allow for the determination of effects on quality of life, postoperative delirium, and postoperative length of stay.
Construction and validation of a risk prediction model for postoperative lung infection in elderly patients with lung cancer
Authors: Chen Xiaojie , Wu Lixin , Lan Gang , Li Xiaofeng , Wang Xuejing , Zhang Ping , Huang Weihu
Published: November 2024

This study aimed to analyze the risk factors for postoperative lung infection in elderly patients with lung cancer (LC) and construct a predictive model. A retrospective analysis was conducted on 192 elderly patients with LC who underwent surgical treatment in our hospital between February 2020 and May 2023. According to whether there is lung infection after surgery, they were divided into an infected group (n = 55) and a noninfected group (n = 137). Binary logistic regression was used to analyze factors influencing postoperative lung infection in elderly patients with LC. Based on the logistic regression results, a predictive model for postoperative lung infection in LC patients was constructed. The receiver operating characteristic curve was used to analyze C-reactive protein (CRP), interleukin-6 (IL-6), insulin-like growth factor-1 (IGF-1), and their combination in predicting postoperative lung infection in patients with LC. There were significant differences between the infected group and the noninfected group in age, smoking history, diabetes, and perioperative antibiotic use were significantly different between the infected and noninfected groups (P < .05). The postoperative CRP, IL-6, and IGF-1 levels in the infected group were higher than those in the noninfected group on the 1st day (P < .05). Logistic regression analysis showed that age > 70 years, history of smoking, history of diabetes, prolonged use of perioperative antibiotics, and elevated CRP, IL-6, and IGF-1 levels on the 1st day after surgery were risk factors for postoperative lung infection in elderly patients with LC (P < .05). Receiver operating characteristic curve analysis showed that the area under curve values of CRP, IL-6, IGF-1, and their combination in predicting postoperative lung infection in elderly patients with LC were 0.701, 0.806, 0.737, and 0.871, P < .05), with sensitivity values of 0.443, 0.987, 0.456, and 0.835, respectively; the specificity was 0.978, 0.525, 0.991, and 0.821, respectively. Age > 70 years, smoking history, diabetes history, prolonged use of perioperative antibiotics, and elevated CRP, IL-6, and IGF-1 levels on the 1st day after surgery have an impact on postoperative lung infection in elderly patients with LC. Early postoperative monitoring of changes in CRP, IL-6, and IGF-1 levels can provide an important reference for predicting the occurrence of postoperative lung infections.
Prevalence of HIV/AIDS among pregnant women in North American region: A systematic review and meta-analysis
Authors: Shabbir Nosheena Akhter , Kant Sara Bashir , Rashid Kainat , Hafeez Uzma , Akbar Aiza Ali , Batool Syeda Wajiha , Pranto Alif Hasan , Zaman Jemema , Shahriyer Tonmoy Hasan , Islam Md Rashedul , Meem M. M. Rubaiyat Muntasir , Islam Dewan Zubaer , Suez Ehsan , Khandker Shahad Saif , Akbar Amna , Khattak Muhammad Iftikhar , Ali Amir Iqbal , Jadoon Sarosh Khan , Shakeel Attarab , Zubair Maryam , Alvi Sarosh
Published: November 2024

Background:

As a major maternal health concern, the prevalence of human immunodeficiency virus (HIV) among pregnant women was previously investigated in European, African, and Latin American regions other than the North American region. This study analyzed the prevalence of HIV among pregnant women in the North American region including 3 major countries: the USA, Canada, and Mexico.

Methods:

Relevant studies were screened from 3 online databases: Google Scholar, PubMed, and ScienceDirect using specific search keywords. Ultimately, 10 studies of the North American region were included with a total of 339,831 pregnant women residing in the USA, Canada, and Mexico.

Results:

The overall pooled prevalence was 0.6% (95% confidence interval [CI]: 0.4–0.8) with a high degree of heterogeneity (I
2 = 97%). Pooled prevalence rates of HIV among pregnant women in Canada, Mexico, and the USA were 0.3% (95% CI: 0.1–0.5), 0.5% (95% CI: 0.2–0.8), and 2.3% (95% CI: 0.0–5.7), respectively with high degrees of heterogeneity.

Conclusion:

The overall prevalence rate of HIV among pregnant women in the USA, Canada, and Mexico was minimal as compared with the countries of Eastern Europe, sub-Saharan Africa, or Latin America. Awareness, adequate testing and healthcare facilities, better socioeconomic, and geopolitical conditions might be crucial to lowering the prevalence of HIV among pregnant women.
Strong association between sarcopenia and visceral fat in the long term after cholecystectomy: A cross-sectional study using the ISarcoPRM algorithm
Authors: Sezer Semih , Demirci Selim , Kara Özgür , Kara Murat
Published: November 2024

Cholecystectomy generally has no adverse effects on health. Studies demonstrating the association between metabolic diseases and long-term effects of cholecystectomy are increasing. preperitoneal fat thickness (PFT) is an important indicator of metabolic syndrome. Metabolic syndrome is a risk factor for sarcopenia. The aim of our study was to investigate the relationship between cholecystectomy and sarcopenia-visceral fat using the ISarcoPRM algorithm, which is an easy, reliable, and inexpensive method based on ultrasound measurement, to evaluate sarcopenia in patients with long-term previous cholecystectomy. This cross-sectional study included participants who had undergone cholecystectomy at least 5 years ago and a control group with similar characteristics. Sarcopenia was assessed using the ISarcoPRM algorithm, incorporating the sonographic thigh adjustment ratio (STAR), grip strength, and chair stand test (CST). Together with low STAR values (<1.0 for females and <1.4 for males), ow grip strength (<19 kg for females or <32 kg for males), and/or prolonged CST duration (≥12 seconds) were used to diagnose sarcopenia. Ultrasound was used to measure the visceral fat thickness. The investigation of sarcopenia and PFT values between individuals with and without cholecystectomy was planned. A total of 158 participants were included, including 89 post-cholecystectomy patients and 69 controls. Binary regression analysis revealed that cholecystectomy was positively associated with sarcopenia (OR = 2.788, 95% CI: 1.054–7.375, P = .039). However, when PFT was included, it was independently associated with sarcopenia (OR = 1.157, 95% CI: 1.067–1.254, P < .001), and the relationship with cholecystectomy disappeared (P > .05). PFT values of 10.0 mm or higher were associated with 5.875 times (95% CI: 2.035–16.961, P = .001) increased odds of sarcopenia. Sarcopenia was 2.8 times more frequent in patients who had undergone cholecystectomy than in those who had not, but this relationship was mediated by increased PFT. The risk of sarcopenia increased up to 5.875 times when the PFT exceeded 10 mm.
The dermatological manifestations and differential diagnosis of monkeypox: A narrative review
Authors: Al-Dabbagh Jacob , Mohammad Deeb Eman , Younis Razan , Eissa Rahaf
Published: November 2024

Monkeypox (MPX) is a zoonotic viral disease caused by the monkeypox virus (MPXV), which belongs to the Orthopoxvirus genus. The main clinical features of MPX are fever, rash, and lymphadenopathy. It is usually a self-limited disease and can resolve within a few weeks in most cases. MPXV is now becoming a global concern. The world health organization declared the outbreak of MPX in 2022 a global health emergency. In this article, we focus on the mucocutaneous manifestations and differential diagnosis of MPX.
Global research trends of virtual simulation technology in public health education and training: A visual analysis based on CiteSpace and VOSviewer
Authors: Dong Yonghai , Ding Sheng , Mao Xiangqun , Liu Xiaoqing
Published: November 2024

Background:

In response to global health challenges, implementing innovative educational strategies is crucial for preparing public health professionals with the required skills. This study employed CiteSpace and VOSviewer to visually analyze 3 decades of research on virtual simulation technology in public health education and training. The visual knowledge map created aimed to uncover the research trends, key areas of interest, and emerging frontiers in this domain.

Methods:

Leveraging the Web of Science core collection database and employing bibliometric methods, the CiteSpace and VOSviewer softwares were used to analyze the annual publication, literature distribution, country/institution distribution, author distribution, co-cited literature, and keywords related to the virtual simulation technology in public health education and training over the past 30 years. A visual map was then created.

Results:

A total of 1241 research articles were involved in the analysis. The yearly publication count and citations had an overall upward trend, with a significant increase in the number of publications since 2019. The studies in this domain are mainly concentrated in developed countries, particularly in Europe and the United States. The United States emerged as the frontrunner in terms of the number of publications, while both the United Kingdom and the United States exhibited the highest mediation centrality and exerted the greatest international influence. Harvard University made the most substantial contribution with 50 articles and exhibited an institutional cooperation centrality of 0.12. The paper entitled “Using thematic analysis in psychology” had the highest number of citations (28). The primary research hotspots included disaster medicine, telehealth, and virtual reality, while aspects such as digital health, augmented reality, and serious games had consistent continuity. An emerging research frontier, Post-2020, included several topics such as medicine, COVID-19, quality, virtual learning, rehabilitation, depression, and strategy.

Conclusion:

This study presents the inaugural comprehensive analysis of global trends, hotspots, frontiers, and advancements in the implementation of virtual simulation technology in public health education and training, utilizing CiteSpace and VOSviewer software. The research findings reveal a significant surge in publications since 2019, with a particular emphasis on disaster medicine, telehealth, and virtual reality, indicating the versatility and promise of virtual simulation in the changing educational environments. These findings emphasize the significance of virtual simulation as a dynamic and progressive tool in public health education, proposing a promising direction for future research and practical applications.
Network pharmacology and experimental verification unraveled the mechanism of Bailing Capsule against asthma
Authors: Lin Shaomei , Chen Mingzhu , Lin Shifeng , Huang Xiaowei , Chen Wanqiong , Wu Shuifa
Published: November 2024

Asthma is a serious public health challenge around the world. Recent studies into traditional Chinese medicine preparations for asthma have yielded promising findings regarding Bailing Capsule’s potential in bronchial asthma prevention and treatment. This study aims to initially clarify the potential mechanism of Bailing Capsule in the treatment of asthma using network pharmacology and in vitro experimental approaches. Network pharmacology was adopted to detect the active ingredients of Bailing Capsule via Traditional Chinese Medicine Systems Pharmacology Database, and the key targets and signaling pathways in the treatment of asthma were predicted. Docking and molecular dynamics simulations were conducted to verify the most important interactions formed by these probes within different regions of the binding site. The predicted targets were validated in lipopolysaccharide-induced 16HBE cell experiment. Seven active ingredients were screened from Bailing Capsule, 294 overlapping targets matched with asthma were considered potential therapeutic targets, such as SRC, TP53, STAT3, and E1A binding protein P300. The main functional pathways involving these key targets include phosphatidylinositol 3-kinase/protein kinase B, mitogen-activated protein kinase, renin–angiotensin system and other signaling pathways, which were mainly involved in the inflammatory response, apoptosis, and xenobiotic stimulus. Moreover, molecular docking showed that Cerevisterol have higher affinity for SRC, TP53, STAT3, and E1A binding protein P300 than other main active components, which is close to the docking results of the co-crystallized ligands to proteins. Consequently, Cerevisterol was selected for molecular dynamics simulation and the results show that Cerevisterol can bind most tightly to SRC, TP53, and STAT3. Bailing Capsule can promote the growth of 16HBE cell, reduce the production of IL-4, TNF-α and IL-6, and down-regulate the levels of SRC and STAT3 mRNA. This study preliminarily reveals the potential mechanism of Bailing Capsule against asthma with the aid of network pharmacology and in vitro cell experiment, which provided reference and guidance for in-depth research and clinical application.
Exercise and physical activity for people with chronic kidney disease: A national survey of nephrologist practice patterns in Saudi Arabia
Authors: Alsolami Enad , Alobaidi Sami
Published: November 2024

A variety of health benefits are associated with physical activity (PA) in individuals with chronic kidney disease (CKD). The aim of this study was to examine nephrologist practice patterns concerning exercise and PA in CKD patients. This is an online cross-sectional survey study that was conducted between June 2023 and May 2024 in Saudi Arabia. Nephrology fellow, specialists, and consultants in Saudi Arabia formed the study population. A total of 96 physicians participated in this study. Only 9.4% of renal units have exercise programs available to patients. These programs are available mainly for advanced CKD (pre-dialysis) and in-center hemodialysis patients. The major barriers for initiating or expanding exercise programs at their centers are a lack of motivation/interest from front-line staff (55.2%), lack of interest from management (48.3%), and no funding (47.1). Around 56.2% of respondents ask patients about their level of PA. Additionally, 64.6% give patients specific advice on how to increase their level of PA. For the types of exercise most beneficial for people with CKD, 90.6% recommend walking. Around 34.4% of respondents believe that physiotherapists should take ownership in providing exercise counseling and resources to people with CKD. The majority agreed or strongly agreed to recommend exercise in patients with CKD (76.0%). The mean attitude score for the study participants was 32.1 (standard deviation: 3.9) out of 40 (equal to 80.3%); which demonstrates positive attitude towards recommending exercise for CKD patients. Binary logistic regression analysis identified that there is no statistically significant difference between physicians in term of their attitude towards recommending exercise for CKD patients (P > .05). This study highlights a critical gap in the availability of exercise programs for CKD patients. Key barriers include lack of interest by staff and management and funding issues. In spite of these barriers, a majority of physicians acknowledge the role of exercise in CKD patients and advice regarding PA on a frequent basis. It suggests recommendations in order to expand the programs, including increasing staff motivation, securing management support, and getting funding for exercise programs and identifying the role of physiotherapists in exercise counseling for CKD patients.
Diagnostic utility of plasma translocator protein 18 kDa (TSPO) in sepsis: A case–control study
Authors: Hattori Miyuki , Kikutani Kazuya , Hosokawa Koji , Kyo Michihito , Nishikimi Mitsuaki , Ota Kohei , Ohshimo Shinichiro , Aizawa Hidenori , Shime Nobuaki
Published: November 2024

Translocator protein 18 kDa (TSPO) is a mitochondrial membrane protein that is involved in inflammation, oxidative stress, and steroidogenesis. TSPO may be a marker of inflammatory responses in the brain and other organs, but there have been few studies of the potential clinical significance of measuring the circulating TSPO concentration, especially in patients with sepsis. In this study, we compared the circulating TSPO concentrations of patients with sepsis and healthy controls to investigate the utility of plasma TSPO for the diagnosis of sepsis. Patients with sepsis admitted to the intensive care unit of Hiroshima University Hospital between January 2020 and April 2024 were enrolled. Plasma samples were collected from patients within 24 hours of admission and also from healthy volunteers, and their plasma TSPO concentrations were compared. Receiver operating characteristic analysis was used to evaluate the usefulness of plasma TSPO concentration for the diagnosis of sepsis. We also investigated the relationships of TSPO concentration with the severity of sepsis, complications, and prognosis of the patients. Eighty subjects (52 patients and 28 controls) were included in this study. The plasma TSPO concentrations of the patients with sepsis were significantly lower than those of the healthy controls (0.094 vs 0.25 ng/mL, P < .001), and receiver operating characteristic analysis generated an area under the curve of 0.81 (95% confidence interval: 0.72–0.91). In patients with sepsis, the TSPO concentration was not associated with the severity of sepsis, complications, or prognosis. Plasma TSPO may be a useful biomarker for the diagnosis of sepsis.
Improved injection site reactions after switching from adalimumab reference to adalimumab biosimilar LBAL for ulcerative colitis: A case report
Authors: Hirakawa Yudai , Kakiuchi Toshihiko , Yoshiura Masato , Kikkawa Nao
Published: November 2024

Rationale:

Adalimumab (ADA) is an antitumor necrosis factor agent that is used for the treatment of inflammatory bowel disease. However, its cost has resulted in varying degrees of restricted access across global healthcare economies. Biosimilars are agents that contain a similar version of the active substance of an already approved original biologic agent and are intended to be used for the same indication as the reference product. In general, biosimilars follow the originator; therefore, information on its efficacy and safety had been few. Some studies have reported on replacement of the originator with a biosimilar of the same efficacy because of medical reasons.

Patient concerns:

A 15-year-old girl with steroid-dependent ulcerative colitis that relapsed after vedolizumab was treated with ADA reference. Six weeks after starting ADA reference, her gastrointestinal symptoms had completely resolved, however, immediately after the eighth dose of ADA reference, redness, swelling, and pruritus were noted at the injection site on the left thigh.

Diagnosis:

Allergic reaction caused by the ADA reference.

Intervention:

ADA reference was changed to ADA biosimilar LBAL.

Outcomes:

ADA biosimilar LBAL was continued without any symptoms, such as local swelling, redness, or itching. In addition, there was no deterioration of gastrointestinal symptoms.

Lessons:

We showed the efficacy and safety of ADA biosimilar LBAL as an alternative to ADA reference, which caused injection site reactions. Changing from ADA reference to ADA biosimilar because of adverse events may be an option that needs careful observation, considering that the originator and the biosimilar are not exactly the same.