bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk stratification model integrating nutritional and inflammatory factors for predicting 1-year mortality after valvular heart surgery: a retrospective cohort study
Authors: Cho Jin Sun , Cho Youn Joung , Shim Jae-Kwang , Jeon Yunseok , Lee Seohee , Choi Hee Won , Kwak Young-Lan
Published: October 2023

Introduction:

Existing risk-scoring systems for cardiac surgery include only standard preoperative factors, without considering nutritional and inflammatory status or intraoperative factors. The objective of this study was to develop a comprehensive prediction model for mortality incorporating nutritional, inflammatory, and perioperative factors in patients undergoing valvular heart surgery.

Materials and methods:

In this retrospective review of 2,046 patients who underwent valvular heart surgery, Cox and LASSO regression analyses were performed to identify independent prognostic factors of 1-year postoperative mortality among various perioperative factors known to affect prognosis, including objective nutritional and inflammatory indices. A novel nomogram model incorporating selected prognostic factors was developed, and its discrimination ability was evaluated using the C-index. The model was validated in internal and external cohorts.

Results:

The 1-year mortality rate after valvular heart surgery was 5.1% (105 of 2,046 patients) and was significantly associated with several preoperative objective inflammatory and nutritional indices. Cox and LASSO analyses identified the following five independent prognostic factors for mortality: monocyte-to-lymphocyte ratio (an objective inflammatory index), EuroSCORE II, Controlling Nutritional Status score, cardiopulmonary bypass time, and number of erythrocyte units transfused intraoperatively. Our nomogram model incorporating these five factors had a C-index of 0.834 (95% CI 0.791–0.877), which was higher than that of EuroSCORE II alone (0.744, 95% CI 0.697–0.791) (P<0.001). The nomogram achieved good discrimination ability, with C-indices of 0.836 (95% CI 0.790–0.878) and 0.727 (95% CI 0.651–0.803) in the internal and external validation cohorts, respectively, and showed well-fitted calibration curves.

Conclusions:

A nomogram model incorporating five inflammatory, nutritional, and perioperative factors, as well as EuroSCORE II, was a better predictor of 1-year mortality after valvular heart surgery than EuroSCORE II alone, with good discrimination and calibration power for predicting mortality in both internal and external validation cohorts.
Effect of mode of delivery of patient reported outcomes in patients with breast disease: a randomised controlled trial
Authors: Pantiora Eirini , Hedman Lia-Chasmine , Aristokleous Iliana , Sjökvist Olivia , Karakatsanis Andreas , Schiza Aglaia
Published: October 2023

Background:

Patient Reported Outcomes (PROs) have an integral role on how to improve patients’ overall experience. The optimal PROs delivery in patients with breast disease is an important issue since PROs are steadily integrated in routine care.

Methods:

An institutional phase 3 randomised controlled, open-label trial. Eligible candidates were adult women with perceived or confirmed breast disease. Computer generated randomisation was used to allocate interventions: collection of PROs in electronic or paper form. Our objective was the effectiveness of electronic versus paper form of PROs. The main outcome measures were: response rate, reported experience, administrative resources and carbon dioxide emissions.

Results:

238 patients were randomised. After loss-to-follow-up and consent withdrawals, 218 participants (median age, iqr=55, 21; n=110 / n=108) were included in the per-intention-to-treat analysis. Response rate was 61.8% for electronic patient reported outcomes (ePROs) and 63.9% for paper patient reported outcomes (pPROs) (difference=−2.1%, 95% CI: -15.8%, 11.7%). Only known breast cancer at recruitment was predictive for response in multivariable analysis. ePROs were associated with 57% reduction in administrative time required, 95% reduction in incremental costs and 84% reduction in carbon dioxide emissions, all differences being significant. No difference was detected in perception of PRO significance or ease of completion, but participants experienced that they needed less time to complete ePROs [median, (iqr) 10 (9) respectively 15(10)]. Finally, respondents would prefer ePROs over pPROs (difference 48.1%, 95%CI 32.8%, 63.4%).

Conclusion:

ePROs do not increase response rate in patients with perceived or confirmed breast disease. However, they can enhance patient experience, reduce incremental costs, facilitate administrative logistics and are more sustainable. On the basis of these findings, both modalities should continue to be available.
Considerations and recommendations on camouflage in alopecia in Black women
Authors: Taye Marta , Kamili Nourine Ahmed , Aguh Crystal , Krueger Loren D.
Published: October 2023

Alopecia is among the leading dermatological concerns affecting Black women. For many women, hair is a central component of identity and self-expression, the loss of which can have significant psychosocial effects. Hair camouflage is often utilized to minimize the visibility of hair loss, provide aesthetic benefits, and improve quality of life. The versatility and affordability of hair camouflage allows patients with alopecia to conceal hair loss, increasing self-confidence, and decreasing social stigma. However, hair camouflage practices often involve adhesives, chemicals, and/or high-tension braiding, all of which can exacerbate alopecia. Accordingly, special considerations should be made to protect patients’ natural hair from damage while using these styling practices. A better understanding of best practices for some of the most widely used camouflage options—wigs, extensions, topical hair fibers, and micropigmentation—can help clinicians establish rapport with Black women and optimize individually-tailored therapeutic plans during active treatment and end-stage hair loss.
Pathophysiology of diabetic kidney disease and autophagy: A review
Authors: Yu Jiawei , Liu Yan , Li Hongjie , Zhang Peirong
Published: October 2023

Diabetic kidney disease (DKD) is one of the main complications of diabetic microangiopathy. The pathogenesis of DKD is very complex, including autophagy, inflammation, oxidative stress. Although a series of treatment intervention have achieved certain results in the treatment of diabetic nephropathy, still cannot reverse the kidney injury of diabetic nephropathy. The kidney is one of the most important organs of energy metabolism. Renal function is highly dependent on phagocytosis of mitochondria, and aberrant or defective autophagic mechanisms are central to the pathology of many renal diseases. Under high glucose conditions, mitochondrial fragments accumulate in the kidney, suggesting that mitochondrial clearance mechanisms may be attenuated with changes in mitochondrial transformation mechanisms. However, the exact mechanism of mitophagy regulation in DKD has not been elucidated. Recent advances in autophagy have renewed interest in these signaling pathways and molecules in the pathogenesis of DKD. Investigating autophagy and its associated signaling molecules may provide potential unique targets for therapeutic intervention in DKD.
Frequency of polymorphisms in the CYP2C9, VKORC1, and CYP4F2 genes related to the metabolism of Warfarin in healthy donors from Cali, Colombia
Authors: Giraldo-Ocampo Sebastian , Diaz-Ordoñez Lorena , Silva-Cuero Yisther Katherine , Gutierrez-Medina Juan David , Candelo Estephania , Diaz Javier A. , Pachajoa Harry
Published: October 2023

Alleles in the VKORC1, CYP2C9, and CYP4F2 genes can influence Warfarin dose requirement. We aimed to determine the frequency of the polymorphisms in these genes in healthy individuals from Cali, Colombia. Observational study where total blood was collected from 107 healthy donors who attended a higher educational institution in Cali, Colombia. Sanger sequencing of exons 2, 3, 5, and 7 of the CYP2C9 gene; the common promoter region of CYP (rs12777823); exon 11 of CPY4F2 and the polymorphism c.-1639G > A in the VKORC1 gene promoter was performed. CYP2C9*2, CYP2C9*3, CYP2C9*8, CYP2C9*9, CYP2C9*11, CYP4F2*3, rs12777823, and VKORC1*2 were detected. The latter had the highest frequency with 80 (74.8%) participants in a heterozygous or homozygous state. The least frequent allele was CYP2C9*11 with only 1 carrier. Combined haplotypes (VKORC1 *1/*2 or *2/*2 and CYP2C9 *1/*2 or *2/*2) were identified in 14 (13.7%) subjects. Both frequencies found in the VKORC1 and CYP2C9 alleles were similar to the ones reported for Latin Americans of European and Native American Ancestry. VKORC1*2 allele, the main genetic contributor to Warfarin dosing requirement, was the variant with the highest frequency (74.8% subjects, with a frequency of the alternative allele (A) of 50%). Our findings provide researchers with a greater insight regarding the frequency of common polymorphisms that affect anticoagulation treatment in the Cali (Colombia) population.
Association of hemoglobin levels at admission with postoperative pneumonia in elderly patients with hip fracture: A retrospective cohort study
Authors: Zhang Daxue , Zhang Ning , Sun Lixin , Zhang Yu , Yang Shiwei
Published: October 2023

Previous studies have suggested a correlation between low preoperative hemoglobin (Hb) levels and postoperative pneumonia (POP) in elderly patients with hip fractures. However, the exact inflection point of Hb level that increases the risk of POP remains unclear. This study aimed to investigate the quantitative relationship between preoperative Hb levels and the incidence of POP in this patient population. This retrospective study included 1417 elderly patients with hip fractures who were admitted to the Department of Orthopedics at Shenzhen Second People’s Hospital between January 2012 and December 2021. Demographic and clinical data, including laboratory test results, were analyzed and compared to explore the relationship between Hb levels at admission and the incidence of POP in this patient population. This study included 1417 elderly patients with hip fractures, comprising 382 males and 1035 females, with a mean age of 77.57 ± 8.73 years. The incidence of POP was 6.21% (88/1417) in this patient population. After adjusting for confounding factors in model II, the regression equation showed that the incidence of POP decreased by 2% with each 1 g/L increment in Hb levels (OR: 0.98, 95% CI: 0.97–1.00; P = .0211). Additionally, a two-piecewise regression model was used to explore the relationship between Hb levels and POP incidence, after adjusting for confounding factors. Threshold effect analysis showed that the inflection point was 83.5 g/L. On the left side of the inflection point, Hb levels were negatively correlated with the incidence of POP (OR: 0.91, 95% CI: 0.86–0.97, P = .0030). There was a nonlinear relationship between preoperative Hb level and POP in elderly patients with hip fractures. When Hb levels were lower than 83.5 g/L, preoperative Hb levels were negatively correlated with POP.
Effect of extracorporeal shock wave combined with pregabalin on patients with post-herpetic neuralgia
Authors: Sun Haoliang , Yu Zhou
Published: October 2023

Post-herpetic neuralgia (PHN) is a chronic pain that is difficult to treat and lasts a long time, which poses a threat to patients’ physical and mental health (MH) and quality of life. To analyze the effectiveness of extracorporeal shock wave (ESW) combined with pregabalin on PHN and its impact on PHN patients’ quality of life with the help of a random number table. Totally 164 PHN patients were assigned to a control group (n = 82) or an observation group (n = 82). The observation group was given pregabalin combined with ESW treatment, while the control group was only given pregabalin. In the 2 groups, the general clinical data of the patients were compared. The inflammation levels including erythrocyte sedimentation rate (ESR), CRP, lymphocyte count and albumin level in both groups were compared prior to and following therapy. In addition, the difference between pretreatment and post-treatment in the 2 groups was compared with respect to neuralgia and quality of life. After treatment, the observation group exhibited much lower ESR and CRP but quite higher lymphocyte count and albumin level relative to the control group (P < .05). Additionally, the improvement in visual analogue scale (VAS) scores and short form 36 (SF-36) scale scores including role-emotional (RE), MH, physical function (PF), general health (GH), bodily pain (BP), social function (SF), vitality (VT), and role-physical (RP) scores in the 2 groups were pronounced following treatment, which was more apparent in the observation group (P < .05). The combination of ESW with pregabalin can reduce the inflammation, improve the quality of life of PHN patients and effectively relieve their neuralgia.
Prognostic significance of LRRC1 in hepatocellular carcinoma and construction of relevant prognostic model
Authors: Cai Qingshan , Wu Dongyang , Shen Yueling , Li Shudong , Liu Liyou , Liu Dong , Li Yong , Chen Xiaonan , Wang Limin , Zheng Jianxing
Published: October 2023

This study aimed to elucidate the prognostic value of the leucine rich repeat containing 1 (LRRC1) gene in hepatocellular carcinoma (HCC) and to determine the effects of high and low LRRC1 expression on mutation and immune cell infiltration. We downloaded HCC mRNA-seq expression and clinical data from University of California Santa Cruz Xena. The expression of LRRC1 was compared between HCC tumor and normal samples. Tumor samples were divided according to high and low LRRC1 expression. Differentially expressed genes between the 2 groups were identified, and function, mutation, and immune cell infiltration were analyzed. Genes associated with immune cells were identified using weighted gene co-expression network analysis, and transcription factors of these genes were predicted. Moreover, a prognostic model was developed and its performance was evaluated. The expression of LRRC1 was upregulated in HCC tissues, and this indicated a poor prognosis for patients with HCC. Differentially expressed genes between high and low LRRC1 expression were significantly enriched in pathways associated with cancer, amino acid metabolism, carbohydrate metabolism, and the immune system. We identified 15 differentially infiltrated immune cells between tumors with high and low LRRC1 expression and 14 of them correlated with LRRC1 gene expression. Weighted gene co-expression network analysis identified 83 immune cell-related genes, 27 of which had prognostic value. Cyclic AMP-response element binding protein regulated annexin A5, matrix metallopeptidase 9, and LRRC1 in the transcription factor regulatory network. Finally, a prognostic model composed of 7 genes were generated, which could accurately predict the prognosis of HCC patients. The LRRC1 gene might serve as a potential immune-associated prognostic biomarker for HCC.
Trends and hotspots in gene research of epilepsy in children: A review and bibliometric analysis from 2010 to 2022
Authors: Tian Yuling , Zhang Xilian , Chen Hanjiang , Li Caiyun , Niu Liqing , Fu Qianfang , Rong Ping , Ma Rong
Published: October 2023

Background:

About 70% to 80% of epilepsy cases are related to genetic factors. Genetic research has revealed the genetic etiology and molecular mechanisms of childhood epilepsy, which has increased our understanding of childhood epilepsy.

Methods:

We searched the core collection of Web of Science for relevant papers on genetic research on childhood epilepsy published since 2010 on November 30, 2022. In this study, original articles and reviews in English were included. Using CiteSpace and VOSviewer online tools, we conducted a bibliometric analysis of the countries, institutions, journals, co-cited journals, co-cited references, keywords, and research hotspots.

Results:

We evaluated 2500 literatures on epilepsy genomics in children. Among them, 96 countries published relevant articles, with the United States ranking the most. A total of 389 institutions have contributed relevant publications, and the University of Melbourne has published the most papers. Epilepsy journals were the most commonly cited. The references of papers were clustered into 9 categories: gene testing, epileptic encephalopathy, Dravet syndrome, focal cortical dysplasia, Rolandic epilepsy, copy number variation, ketogenic diet, monogenic epilepsy, and ptt2 mutation. Burst keywords represent the frontier of research, including developmental and epileptic encephalopathy (2021–2022), neurodevelopmental disorders (2020–2022), gene testing (2020–2022), and whole-exome sequencing (2019–2022).

Conclusion:

This study conducted a systematic and objective bibliometric analysis of the literature on epilepsy gene research in children. More importantly, it revealed the hot spot, frontier, and future developmental trends in the field. It will help pediatricians and geneticists further understand the dynamic evolution of genetic research on pediatric epilepsy.
Traditional Chinese Medicine for non-motor symptoms in Parkinson disease: A systematic review and meta-analysis of RCTs
Authors: Huang Liqing , Hong Junru , Wang Yang
Published: October 2023

Background:

Parkinson disease (PD) is the second most common neurodegenerative disease, which has impacts on the patient’s quality of life due to non-motor symptoms such as sleep disorders, anxiety, and depression. Traditional Chinese medicine (TCM) has gained increasing attention in the diagnosis and treatment of PD with the concept of “overall concepts and dialectical treatment.” Therefore, exploring the characteristics of TCM in the treatment of PD can improve the level of diagnosis and treatment of PD.

Methods:

A comprehensive literature search was conducted using the following electronic databases: PubMed, Web of Science, Embase, Scopus, Cochrane Library, and China National Knowledge Infrastructure. The inclusion criteria were randomized controlled trials (RCTs) that compared TCM intervention with conventional treatments or placebo for non-motor symptoms in PD. The quality of the included RCTs was assessed using the Cochrane risk of bias tool.

Results:

A total of 9 RCTs involving 1714 participants with PD were included in this systematic review and meta-analysis. The meta-analysis showed that TCM was effective in improving non-motor symptoms, including depression (Hamilton depression rating scale [HAMD], weighted mean difference [WMD] = 4.24, 95% CI = 2.84–5.65, P < .0001), anxiety (HAMA, WMD = 4.03, 95% CI = 2.64–5.41, P < .0001), autonomic dysfunction (Scales for Outcomes in Parkinson’s disease–Autonomic, WMD = 4.57, 95% CI = 1.69–7.45, P = .002), non-motor symptoms (Movement Disorder Society-Unified Parkinson’s Disease Rating Scale-part 1, WMD = 0.66, 95% CI = 0.20–1011, P = .004), and quality of life (PDQ-39, WMD = 6.72, 95% CI = 0.87–12.58, P < .05), compared with baseline. Zishen Pingchan granules was particularly effective for depression (HAMD, WMD = −1.94, 95% CI = −3.07 to −0.81, P < .001, compared to placebo; HAMD, WMD = 3.40, 95% CI = 0.52–6.28, P < .05, after treatment). Pingchan granules was particularly effective for quality of life after treatment (PDQ-39, WMD = 10.20, 95% CI = 1.87−18.53, P < .05).

Conclusions:

TCM is effective and safety for improvement of depression, anxiety, autonomic dysfunctions, and quality of life in PD. Zishen Pingchan granules was particularly effective for depression; and Pingchan granules was particularly effective for quality of life.
Effects of structured exercise program on severity of dizziness, kinesiophobia, balance, fatigue, quality of sleep, activities of daily living, and quality of life in bilateral vestibular hypofunction
Authors: Genç Sena Gizem , Budak Miray , Yilmaz Mahmut Sinan , Algun Zeliha Candan
Published: October 2023

Background:

A minimal number of studies have documented the impact of Vestibular rehabilitation (VR) on the recovery rate of patients with bilateral vestibular hypofunction (BVH).

Objective:

The purpose of this study was to investigate the effectiveness of structured VR programs on severity of dizziness, kinesiophobia, balance, fatigue, quality of sleep, activities of daily living (ADL) and quality of life (QoL) in subjects with chronic BVH.

Method:

Twenty-five participants diagnosed with BVH were included in the study. A structured VR program was applied in 50-minute sessions once a week and as a home exercise program 3 times a day over 8 weeks. Participants were evaluated for severity of dizziness with the visual analog scale, for kinesiophobia with the tampa scale of kinesiophobia, for balance with the Semitandem, tandem, and standing tests, for quality of sleep with the Pittsburgh sleep quality index, for ADL with the vestibular disorders activities of daily life, for QoL with dizziness handicap inventory and for fatigue with the fatigue severity scale at the baseline (T1), at 4th week (T2), 8th week (T3), and 20th week (T4) after study started.

Results:

Significant difference in terms of Tandem Test and 1 Leg Stand Test was found in favor of T3-T4 Period (P < .05). There were significant improvements in terms of vestibular disorders activities of daily life, tampa scale of kinesiophobia, Pittsburgh sleep quality index and dizziness handicap inventory in favor of the T3 to T4 Period (P < .05). Significant difference in terms of visual analog scale was found in favor of T2 Period (P < .05).

Conclusions:

A twelve-week structured VR program may enhance severity of dizziness, kinesiophobia, balance, quality of sleep, ADL and QoL in participants with chronic BVH.
Assessment of vasa vasorum on coronary plaques in patients with acute coronary syndromes using intravascular ultrasound and iMap analysis: A retrospective cohort study
Authors: Wu Xi , Ji Gang , Wang Quan , Chen Jing , Cai Xin-Yu , Song Jing , Yan Yan , Huang He
Published: October 2023

Studies have revealed that vasa vasorum (VV) neovascularization is vital for the progression and vulnerability of coronary atherosclerotic plaques. The correlation between VV, plaque constituents, and the no-reflow phenomenon (NRP) in percutaneous coronary intervention (PCI) remains elusive. We explored plaque constituents in iMap-intravascular ultrasound (iMap-IVUS) and NRP during PCI for VV lesions. We studied 166 coronary lesions in 166 patients with acute coronary syndromes (ACS) (118 lesions with VV) undergoing pre-intervention intravascular ultrasound (IVUS). We evaluated the diversity in plaque morphological status and post-PCI results based on the presence or absence of VV. The lesions with VV group had significantly higher high-sensitivity C-reactive protein (hs-CRP) levels than the lesions without VV group (8.41 ± 4.98 vs 4.19 ± 3.69 mg/L, P < .001). The frequency of after-stent deployment thrombolysis in myocardial infarction (TIMI) flow grades 0, 1, and 2 was remarkably greater in lesions with VV than in those without VV (22.9% vs 10.4%, P < .001). Plaques at the minimum lumen, necrotic core (1.26 ± 0.64 vs 0.92 ± 0.61 mm2, P < .001; 20.95 ± 7.19 vs 13.34% ± 6.54%, P < .001), and fibrous areas (4.23 ± 1.32 vs 3.92 ± 1.01 mm2, P = .006; 61.01 ± 9.41 vs 56.92% ± 11.42%, P = .001) were considerably larger in the lesions with VV than in those without VV. In addition, densely calcified plaques (0.41 ± 0.26 vs 0.81 ± 0.59 mm2, P < .001; 3.63 ± 2.19 vs 7.18% ± 2.01%, P < .001) were considerably smaller in the lesions with VV than in those without VV. Multivariate analyses revealed that VV and plaque volume were independent predictors of NRP after stent deployment (odds ratio [OR]: 5.13, 95% confidence interval [CI]: 1.19–15.32, P = .002; OR: 4.79, 95% CI: 1.08–9.01, P = .005). Lesions with VV exhibited considerable plaque vulnerability in patients with ACS, and they displayed more NRP during PCI. VV and plaque volume were independent predictors of NRP after stent deployment.
Evolutionary overview of sarcopenia – bibliometric study on the Web of science: A review
Authors: Chen Juan , Wang De-jun , Zhang Yi-chen , SU Yan-hong
Published: October 2023

Sarcopenia is an age-related degenerative disease associated with adverse outcomes such as falls, functional decline, weakness, and mortality. Exploring the dynamic evolutionary path and patterns of sarcopenia research topics within a temporal framework from the perspective of strategic coordinate maps and data flow can help identify the development rules of sarcopenia themes. After searching, a total of 16,326 articles were obtained. There are few early research topics, but the development maturity of the topics is high; the number of late research topics continues to increase, showing a trend of diversified development. The differentiation and fusion of the theme evolution path are obvious, and the theme inheritance index is high. The development trend of this research field is promising. The mature and stable professional topics such as “RESISTANCE EXERCISE” and “SURVIVAL” that appeared in the late stage belong to the core topics, while newly emerging topics like “FRACTURES” and “PROTEIN” belong to the marginal topics, indicating that the research on muscle and bone metabolism in the field of sarcopenia has yet to be further in-depth, and the “CANCER” topic is a highly promising research topic with strong development potential.
Prognostic value of platelet-to-basophil ratio (PBR) in patients with primary glioblastoma
Authors: Yang Chao , Xu Jian , Wang Jie , Li Zhiqiang , Yao Qiong
Published: October 2023

Inflammation is strongly associated with cancers. Our research explored the prognostic role of hematological inflammatory indicators in patients with glioblastoma (GBM). Hundred patients were incorporated finally, and we determined the best cutoff values of these blood markers through X-tile first to perform further survival tests. The prognostic role of peripheral blood cell count and corresponding ratios were assessed using the Kaplan–Meier curve and Cox models to identify variables with independent prognostic significance. Then, variables with independent predictive values were incorporated in constructing the nomogram model to realize quantitative prediction for survival. Nomograms were evaluated using Harrell concordance index, receiver operating characteristic curves, and decision curve analysis to assess clinical benefit. Multivariate analysis indicated that a higher platelet-to-basophil ratio (PBR) (>4575) (hazard ratio = 1.819, 95% confidence interval: 1.110–2.980, P = .018) was associated with poorer overall survival in GBM patients. Based on the PBR nomogram, the predictive accuracy was moderate (concordance index = 0.844, area under curve = 0.632). The PBR could serve as a prognostic biomarker for overall survival in patients with GBM, and nomogram models incorporating the PBR could facilitate comprehensive preoperative survival assessment.
The effects of exercise intervention on complications and pregnancy outcomes in pregnant women with overweight or obesity: A systematic review and meta-analysis
Authors: Kuang Jun , Sun Suwen , Ke Fengmei
Published: October 2023

Background:

Being overweight or obese is closely related to adverse pregnancy outcomes and harms both pregnant women and neonates, increasing complications during pregnancy and leading to adverse pregnancy outcomes. Consequently, a meta-analysis was done to investigate exercise therapy impact on the complications and outcomes of pregnant women who are obese or overweight.

Materials and Methods:

The computer system searched PubMed, Cochrane Library, Wanfang, EMBASE, and CNKI databases. The search duration extended from the database establishment until October 2022. A thorough search was carried out for pertinent studies investigating exercise therapy impact on pregnancy complications and outcomes in obese or overweight pregnant women. The heterogeneity test was carried out using Cochrane Q and Chi-square tests. The combined findings from the meta-analysis were examined for reliability and robustness using sensitivity and publication bias analyses. All statistics used RevMan 5.3 software.

Results:

This meta-analysis included data from 8026 patients from 22 randomized controlled trials. The results demonstrated that exercise therapy might successfully decrease the incidence of gestational diabetes mellitus (GDM) (odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.74–0.96, P = .01) and macrosomia (OR = 0.78, 95% CI: 0.68–0.89, P < .001), and control weight gain during pregnancy (SMD = −0.2, 95% CI: −0.31 to −0.08, P < .001).

Conclusions:

Exercise therapy can control weight gain during pregnancy, lower the incidence of GDM and the macrosomia rate, and improve adverse pregnancy outcomes.
Clinical features and outcomes of Myasthenia Gravis associated with COVID-19 vaccines: A systematic review and pooled analysis
Authors: Tayebi Amir Hossein , Samimisedeh Parham , Jafari Afshar Elmira , Ayati Aryan , Ghalehnovi Elaheh , Foroutani Laleh , Abbasi Khoshsirat Nahid , Rastad Hadith
Published: October 2023

Backgrounds:

Myasthenia Gravis (MG), a chronic neuromuscular junction disorder, emerged as one of the serious side effects of the Coronavirus Disease 2019 (COVID-19) vaccination. We aimed to summarize the findings of studies on the clinical features and outcomes of COVID-19 vaccination-associated MG.

Methods:

We performed a systematic search on 3 databases, Medline, Embase, and Scopus, using the query “COVID-19 vaccine” and “Myasthenia Gravis.” Patients’ data, including clinical data, MG subtype, vaccine type, and vaccine dose number, were extracted from the eligible studies.

Results:

A total of 20 COVID-19 vaccination-related MGs have been reported worldwide. The median (interquartile range) age was 64 (51, 75) years; 85% (17/20) of them were male, and 70% (14/20) of patients had received messenger RNA-based vaccines. The most common symptoms, in order of frequency, were binocular diplopia (8/11) and ptosis (4/11); the median (interquartile range) time from vaccine to MG symptoms was 6 (2, 7.5) days. Repetitive nerve stimulation showed abnormal decrement in 85% (11/13) of patients, and all 4 patients getting single-fiber electromyography showed an abnormal finding. Nine out of twelve patients with data on clinical outcomes experienced partial/complete improvement of symptoms within 1 month.

Conclusion:

MG cases after the COVID-19 vaccine are more likely to occur among males and adults older than 50 years. Our pooled cohort data suggest MG symptoms appear within 2 weeks after receiving the vaccine. The presenting symptoms in MG cases associated with COVID-19 vaccine are possibly similar to non-vaccination related MGs. Most patients are expected to experience partial/complete improvement within 1 month.
Prognostic factors affecting the ruptured intracranial aneurysms: A 9-year multicenter study in Fujian, China
Authors: Huang Qiu-Yu , Huang Qing , Lin Shao-Wei , Wang Fan , Sun Yi , Zeng Yi-Le , Liu Bang , Cai Ying-Ying , Chen Ze-Long , Wu Si-Ying
Published: October 2023

Background:

A multicenter retrospective study was conducted to explore the factors affecting short-term prognosis and long-term outcomes of intracranial aneurysms (IA) rupture. Further, the prognosis prediction model was constructed based on survival analysis, contributing to the development of prevention strategies for aneurysmal subarachnoid hemorrhage.

Methods:

Data of 1280 patients with IA rupture were gathered between 2014 and 2022 in Fujian, China. Logistic regression was implemented to study the short-term prognostic factors of IA rupture. Survival analysis of 911 patients among them was performed to explore the long-term outcome status by Cox risk assessment. Nomogram prognosis models were constructed using R software.

Results:

The findings displayed that blood type O (OR = 1.79; P = 0.019), high systolic pressure (OR = 1.01; P < 0.001), Glasgow Coma score (GCS) 9–12 (OR = 2.73; P = 0.022), GCS < 9 (OR = 3.222; P = 0.006), diabetes (OR = 2.044; P = 0.040), and high white blood cell count (OR = 1.059, P = 0.040) were core influencing factors for poor short-term prognosis. Survival analysis revealed that age > 60 years (HR = 2.87; P = 0.001), hypertension (HR = 1.95; P = 0.001), conservative (HR = 6.89; P < 0.001) and endovascular treatment (HR = 2.20; P = 0.001), multiple ruptured IAs (HR = 2.37; P = 0.01), Fisher 3 (HR = 1.68; P = 0.09), Fisher 4 (HR = 2.75; P = 0.001), and Hunt-Hess 3 (HR = 0.55; P = 0.05) were the major risk factors for terrible long-term outcomes.

Conclusions:

People over 60 years with characteristics of type O blood, high systolic pressure, diabetes, high white blood cell count, and onset GCS < 12 will have more complications and a worse short-term prognosis. Those aged > 60 years with hypertension, conservative and endovascular treatment, multiple ruptured IAs, Fisher ≥ 3 and Hunt-Hess 3 have a greater risk of poor long-term prognosis.
Effects of acute moderate-intensity aerobic exercise on cognitive function in E-athletes: A randomized controlled trial
Authors: Zhang Weichao , Wang Xiaoqiang , Li Xun , Yan Hongqiao , Song Yuanyuan , Li Xinying , Zhang Wenhua , Ma Guoao
Published: October 2023

Background:

E-sports require athletes to have high-speed reflexes and excellent memory skills. Whereas a single session of aerobic exercise has been shown to improve cognitive function, this paper aims is to investigate the effects of acute moderate-intensity aerobic exercise on the cognitive function of e-sports players and its time-course characteristics.

Methods:

Thirty-four E-athletes were divided into 2 groups according to a random number table method, and 2 trials in a quiet physical fitness gym. The duration of each trial was approximately 1 hour. In the first trial: exercise group (64–76% of maximum heart rate for 30 minutes power cycling) and control group, cognitive function was tested, and results were automatically recorded before, immediately after, and 30 minutes after exercise using the human benchmark website (https://humanbenchmark.com). The second trial crossed and swapped the interventions of the 2 groups, and the other test protocols were the same as the first.

Results:

In both trials, the exercise intervention group showed significant improvements in speed accuracy (P < .001, Cohen’s d = 1.406, 95% CI: 0.717–2.072; P = .005, Cohen’s d = 0.782, 95% CI: 0.227–1.319), visual memory (P < .001, Cohen’s d = 1.416, 95% CI: 0.725–2.086; P = .015, Cohen’s d = 0.662, 95% CI: 0.127–1.181), and reaction time (P < .001, Cohen’s d = 1.265, 95% CI: 0.610–1.898; P<.001, Cohen’s d = 0.979, 95% CI: 0.386–1.551) immediately after exercise compared to baseline. The exercise intervention group also showed significant improvement in speed accuracy 30 minutes after exercise compared to baseline (P = .002 Cohen’s d = 0.869, 95% CI: 0.298–1.421; P = .009, Cohen’s d = 0.722, 95% CI: 0.177–1.249). In the first trial, the exercise intervention group showed significant improvements in visual memory and reaction time immediately after exercise compared to the control group (P = .013, Cohen’s d = 0.904, 95% CI: 0.190–1.605; P = .027, Cohen’s d = 0.796, 95% CI: 0.090–1.490). The exercise intervention group also showed significant improvement in reaction time 30 minutes after exercise compared to baseline (P = .009, Cohen’s d = 0.719, 95% CI: 0.174–1.246). There was no effect of exercise on sequence memory or the chimp test in both trials (P > .05). Sequence effect analysis showed no influence on the order of the exercise intervention in both trials (P = .912; P = .111; P = .226).

Conclusion:

Acute moderate-intensity aerobic exercise significantly enhanced the speed accuracy, visual reaction time, and instantaneous memory of eSports players, and the effect could be extended up to 30 minutes after exercise.
Shared genetic links between bladder cancer and obesity-related traits: A conjunctional false discovery rate study
Authors: Chen Jiaqi , Li Hu , Wu Yongyang , Li Yahui , Liao Shangfan
Published: October 2023

Bladder cancer (BCa) is a common cancer worldwide and is often linked with obesity-related comorbidities, but little is known about the underlying genetic mechanisms. To investigate these mechanisms, we used various quantitative tools, including conditional quantile-quantile (Q-Q) plots, conditional false discovery rate (cFDR), and conjunctional conditional false discovery rate (ccFDR), to explore the pleiotropic enrichment of risk loci between BCa and obesity-related traits. We also performed an expression quantitative trait locus (eQTL) analysis to assess the relationship between shared risk loci and gene expression. Finally, we conducted functional annotation using Kyoto Encyclopedia of Genes and Genomes (KEGG) and gene ontology (GO) analysis. Our findings indicated that there was successive enrichment for a range of obesity-related traits, including body fat percentage, body mass index, fasting insulin, type 2 diabetes mellitus, fasting glucose, high-density lipoprotein cholesterol, total triglycerides, and waist-to-hip ratio. Using the tools mentioned above, we identified 18 significant SNPs and 18 closely related genes (cFDR<0.01) under the condition of 8 obesity-related traits. The SNPs included rs143004880, rs73301337, rs10798572, rs11594929, rs17019138, rs2877, rs149795948, rs142509736, rs12727575, rs1571277, rs12131828, rs635634, rs76895963, rs118081211, rs7044247, rs138895564, rs4135275, and rs148023060. Additionally, we identified 15 novel loci using ccFDR, including rs143004880, rs73301337, rs10798572, rs11594929, rs17019138, rs2877, rs142509736, rs1571277, rs635634, rs76895963, rs12131828, rs118081211, rs7044247, rs138895564, and rs4135275. Of the 2 significant loci that modify gene expression, rs12131828 and rs635634 were identified. The functional annotation indicated that the conditional risk genes mainly participated in the regulation of gene silencing. Our study provided evidence of pleiotropic enrichment between BCa and 8 obesity-related traits, and we identified potential genetic mechanisms underlying this relationship. These findings may help in developing targeted clinical treatments for BCa.
Modified Suanzaoren decoction in treating post-stroke cognitive impairment with comorbid insomnia symptoms: A clinical trial
Authors: Zhu Mingjin , Pan Guoyua , Luo Fang , Sui Shuyan , Zhang Yonghua
Published: October 2023

Background:

Cognitive impairment and insomnia are common complications for stroke patients, and often coexist without effective therapy. Modified Suanzaoren decoction (M-SZRD), derived from a famous classic prescription, has been used as an alternative treatment for these patients. The objective of this study is to investigate the effectiveness of M-SZRD in treating post-stroke cognitive impairment with comorbid insomnia symptoms.

Methods:

A total of 80 participants were randomly assigned into 2 groups to 40 cases in the treatment group (treated with modified Suanzaoren decoction) and 40 cases in the control group (treated with zolpidem). The intervention period was 4 weeks. Cognitive function, sleep quality, depression, and anxiety disorders were evaluated in both groups before and after treatment. Clinical assessment of patients with stroke included National Institutes of Health Stroke Scale and Barthel Index evaluations. Hormone levels of the hypothalamic-pituitary-adrenal and hypothalamus-pituitary-thyroid axis were also measured.

Results:

Out of the total 80 participants, 5 withdrew during the experiment and did not complete the study, leaving 75 patients for analysis to 38 in the treatment group and 37 in the control group. The findings showed that M-SZRD was more effective than the control group in improving cognitive function (P = .006). However, both groups were found to have a similar effect in improving insomnia (P = .323). There was no significant difference between the 2 groups in terms of activities of daily living and National Institutes of Health Stroke Scale improvement. M-SZRD was superior to the control group in improving depression state (P = .034), but when including dropouts in the intention-to-treat analysis, the difference was not statistically significant (P = .150). Furthermore, the M-SZRD group was better than the control group in reducing cortisol levels (P = .036), and the improvement in serum-free triiodothyronine (FT3) levels was also more significant in the M-SZRD group than in the control group (P = .0007).

Conclusion:

M-SZRD is a more effective treatment for improving cognitive function in patients with post-stroke cognitive impairment and comorbid insomnia symptoms, possibly by regulating the cortisol levels of the hypothalamic-pituitary-adrenal axis and FT3 levels of the hypothalamus-pituitary-thyroid axis.
Clinical efficacy of Huanglian Wendan decoction in treating type 2 diabetes mellitus: A systematic review and meta-analysis
Authors: Tian Yuan , Pang Guowei , Pan Linlin
Published: October 2023

Background:

Huanglian Wendan decoction (HLWDD) is a traditional Chinese prescription, which has been used to treat type 2 diabetes mellitus (T2DM) in recent years. However, no studies have evaluated its underlying clinical efficacy. Therefore, we used systematic review and meta-analysis to explore the clinical efficacy of HLWDD in treating T2DM.

Methods:

The randomized controlled trials of HLWDD on T2DM were retrieved from Chinese and foreign databases. The primary outcomes included fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG), and glycosylated hemoglobin, type A1c (HbA1c). The secondary outcomes included fasting serum insulin, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c). Statistical analyses were performed using Review Manager and Stata software. Mean difference (MD) with 95% confidence intervals (CI) were used to describe results. The grades of recommendation assessment, development and evaluation approach was used to rate the quality of the evidence; and trial sequential analysis was used to evaluate the required information size and treatment benefits.

Results:

Twenty-three randomized controlled trials were included in this study. We showed that HLWDD can improve FBG (MD = −0.99, 95% CI: −1.10 to −0.88), 2hPG (MD = −1.57, 95% CI: −1.97 to −1.17), HbA1c (MD = −1.11, 95% CI: −1.42 to −0.80), HOMA-IR (MD = −0.80, 95% CI: −1.80 to −0.51), TC (MD = −0.65, 95% CI: −0.88 to −0.42), TG (MD = −0.32, 95% CI: −0.38 to −0.27), LDL-c (MD = −0.54, 95% CI: −0.66 to −0.41), and HDL-c (MD = 0.08, 95% CI: 0.02–0.15) levels in T2DM patients. Trial sequential analysis suggested that the eficacy of HLWDD in improving FBG, 2hPG, HbA1c, HOMA-IR, TC, TG, LDL-c, and HDL-c was sufficient to draw a firm conclusion. Grades of recommendation assessment showed that HLWDD only has high or moderate quality of evidence in improving FBG, and TG.

Conclusion:

HLWDD can improve blood glucose and blood lipid levels in T2DM patients, and may be a potential drug to treat T2DM.
Prognostic value of lymph node ratio in stage III non-small-cell lung cancer: A retrospective cohort study
Authors: Zhang Xiang , Feng Nan , Wu Bo , Wei Yiping , Zhang Wenxiong
Published: October 2023

A growing number of studies have found that the lymph node ratio (LNR) is an important indicator of prognosis in non-small-cell lung cancer (NSCLC). Impact analysis for LNR was performed for survival in patients undergoing surgery for stage III NSCLC compared to the surveillance, epidemiology and end results databank. Clinicopathological variables, such as cancer-specific survival (CSS), were taken from the surveillance epidemiology and end result databank of stage III NSCLC patients who underwent surgery, and the LNR threshold stratification of NSCLC patients was computed by X-tile. CSS was assessed by the Kaplan–Meier method with CSS-independent risk factors calculated by multivariate Cox regression analysis. In total, 7011 lung cancer patients were included. Multifactorial analysis showed that LNR and positive node category had predictive value for stage III NSCLC. In patients with stage IIIA NSCLC, Kaplan–Meier analysis demonstrated that patients with T1-2N2 stage had clearly superior CSS than those with T3-4N1 stage (P < .001), which conflicted with the results from the assessment of primary tumor, lymph nodes, and metastasis/N stage. The cutoff values for LNR were 0.31 and 0.59. Kaplan–Meier analysis demonstrated that the CSS was substantially better in patients with LNR-low than in those with LNR-medium or LNR-high (P < .001), which was also proven by multivariate competing risk regression. Subgroup analysis suggested that the survival advantage of a lower LNR was achieved in all subgroups (sex, race, etc). In stage III NSCLC, the LNR is a valuable factor for assessing prognosis, in which a higher LNR indicates a worse prognosis.
Efficacy and safety of caffeic acid tablets in the treatment of thrombocytopenia: A systematic review and meta-analysis
Authors: Yu Hongxiu , Chen Ruixiang , Zhou Zhengwen , Liu Rongchun , Wen Jin
Published: October 2023

Background:

Caffeic acid tablets (CFA) are a proprietary Chinese medicine in treating thrombocytopenia. The efficacy and safety of CFA compared with other platelet-raising drugs for the treatment of thrombocytopenia have been widely reported in the literature, but there is no systematic evaluation. Therefore, we designed this meta-analysis to further establish the efficacy and safety of CFA in treating thrombocytopenia.

Methods:

A computerized search was conducted in the Chinese biomedical database (CBM), Chinese National Knowledge Infrastructure (CNKI), Wanfang database, Chinese Scientific Journal Database (VIP), PubMed, and Web of Science databases using the keywords “caffeic acid tablets” and “thrombocytopenia.” All randomized controlled trials were selected for the timeframe of build to 02/2023 and then screened and analyzed using RevMan 5.4 and stata17.0 software.

Results:

A total of 35 publications with an overall 2533 patients were included in the study. The results of the meta-analysis showed that CFA were effective in the treatment of thrombocytopenia with a statistically significant difference [relative risk ratio (RR) = 1.24, 95% CI (1.17, 1.31), P < .00001] and in increasing platelet counts [standardized mean difference (SMD) = 1.50, 95% CI (1.09, 1.91), P < .00001], white blood cell count [SMD = 1.08, 95% CI (0.77, 1.39), P < .00001], and neutrophil count [SMD = 0.73, 95% CI (0.19, 1.28), P = .009], and CFA reduced myelosuppression [RR = 0.19, 95% CI (0.1, 0.37), P < .00001] and adverse effects [RR = 0.75, 95% CI (0.58, 0.96), P = .02].

Conclusion:

CFA can effectively improve the clinical outcome of patients with thrombocytopenia with a good safety profile and are worth promoting. However, due to the low quality and small sample size of the included literature, a larger sample size and more standardized, high-quality studies are needed to validate these results.