bluuebunny/crossref_metadata_2025 huggingface dataset:
Mediation by Fatalism of the Association Between Symptom Burden and Self-care Management in Patients With Heart Failure
Authors: Thapa Ashmita , Chung Misook L. , Wu Jia-Rong , Latimer Abigail , Lennie Terry A. , Mudd-Martin Gia , Lin Chin-Yen , Thompson Jessica Harman , Kang JungHee , Moser Debra K.
Published: October 2023

Background

Clinicians and researchers often assume that symptom burden is associated with self-care management (SCM) in patients with heart failure (HF). However, that association is often not borne out in simple regression analyses and may be because another variable mediates the association. Fatalism is an appropriate candidate for mediation and is the belief that circumstances are predetermined without opportunity for control by individuals.

Objective

Our objective was to determine whether fatalism mediated the relationship of symptom burden with SCM among adults with HF.

Methods

We conducted a secondary analysis (N = 95) from a clinical trial. We used Self-care of HF Index to measure SCM, the Memorial Symptom Assessment Scale-HF for symptom burden, and the Cardiovascular Disease Fatalism Instrument to measure fatalism. We used the PROCESS macro to evaluate mediation.

Results

Symptom burden was not directly associated with SCM (effect coefficient [C'] = 0.0805; 95% confidence interval, −0.048 to 0.209;P= .217). There was, however, an indirect pathway between symptom burden and SCM through fatalism (ab= −0.040; 95% confidence interval, −0.097 to −0.002). Those with higher symptom burden were more fatalistic (a= 0.004,P= .015), and greater fatalism was associated with worse SCM (b= −9.132,P= .007).

Conclusion

Symptom burden, not directly associated with SCM, is associated through the mediator of fatalism. Interventions to improve SCM should include strategies to mitigate fatalistic views. Self-care management interventions should focus on promoting internal locus of control or increasing perceptions of perceived control to decrease fatalism and improve engagement in self-care.
Comparative study on clinical outcomes and cost-effectiveness of chronic subdural hematomas treated by middle meningeal artery embolization and conventional treatment: a national cross-sectional study
Authors: Tong Xin , Xue Xiaopeng , Liu Aihua , Qi Peng
Published: October 2023

Background:

We compared the efficacy and cost-effectiveness of middle meningeal artery embolization (MMAE) and conventional treatment for chronic subdural hematomas (cSDH).

Methods:

The Nationwide Readmissions Database of 9963 patients (27.2% women) with cSDH between 2016 and 2020 was analyzed. Finally, 9532 patients were included (95,7%, treated conventionally; 4,3%, treated with MMAE). Baseline demographics, comorbidities, adverse events, treatment strategies, and outcomes were compared between patients treated with MMAE and conventional treatment. After propensity score matching (PSM), we compared primary outcomes, including 90-day treatment rate, functional outcome, length of hospital stays, and cost. A Markov model estimated lifetime costs and quality-adjusted life years (QALYs) associated with different treatments. The incremental cost-effectiveness ratio (ICER) was calculated to evaluate the base-case scenario. One-way, two-way, and probabilistic sensitivity analyses were performed to evaluate the uncertainty in the results.

Results:

After PSM, MMAE had a lower 90-day retreatment rate (2.6% vs. 9.0%,P= 0.001), shorter length of hospital stays (4.61±6.19 vs. 5.73±5.76 d,P=0.037), similar functional outcomes compared (favorable outcomes, 80.9% vs. 74.8%,P=0.224) but higher costs ($119757.71±90378.70 vs. $75745.55±100701.28,P<0.001) with conventional treatment. MMAE was associated with an additional cost of US$19280.0 with additional QALY of 1.3. Its ICER was US$15199.8/QALY.

Conclusion:

MMAE is more effective in treating cSDH than conventional treatment. Based on real-world data, though MMAE incurs higher overall costs, the Markov model showed it to be cost-effective compared to conventional treatment under the American healthcare system. These comparative and economic analyses further support the consideration of a paradigm shift in cSDH treatment.
Local resection for solid pseudopapillary neoplasms of the pancreas shows improved postoperative gastrointestinal function and reduced mental stress: a multi-questionnaire survey from a large cohort
Authors: Hua Yuze , Hong Xia , Dai Menghua , Li Jiayi , Yang Sen , Guo Junchao , Wang Weibin , Xu Qiang , Han Xianlin , Wang Mengyi , Huang Nan , Zheng Huaijin , Kleeff Jorg , Liu Qiaofei , Wu Wenming , Zhang Taiping , Liao Quan , Zhao Yupei
Published: October 2023

Background:

Solid pseudopapillary neoplasm of the pancreas (SPN) is a rare, low-grade malignant pancreatic tumor with a highly favorable prognosis. Most SPN patients are young and middle-aged women. The main controversial topic for SPN is local resection (LR) versus radical resection (RR). Theoretically, local resection could lead to better gastrointestinal function (GIF) and less mental stress. However, no data is available to support this hypothesis.

Methods:

All SPN patients undergoing surgical treatment in XXXXXXXX Hospital from 2001 to 2021 were included in the study. A cross-sectional online multi-questionnaire survey containing 110 questions was sent to them (XXXXXXX). This online multi-questionnaire survey focused on GIF and mental stress and consisted of eight questionnaires. Multiple linear regression analysis was conducted to identify independent factors impacting GIF and mental stress.

Results:

A total of 183 cases provided valid results. Among them, 46 patients (25.1%) underwent LR, and 137 (74.9%) underwent RR. Ninety-four cases (51.4%) underwent minimally invasive surgery (MIS), while 89 (48.6%) underwent open surgery. The average GSRS score of the patients was 1.9±0.7, indicating that most suffered from mild gastrointestinal dysfunction. The scores of PHQ-9 and GAD-7 in 16 patients (8.7%) and 27 (14.8%) patients, respectively, were beyond 10.0, which indicated clinical depression and anxiety. Additionally, 19 (10.4%) patients reported poor ability to work, and 31(16.9%) patients had significant body image concerns. Compared to other clinicopathological characteristics, LR (LR vs. RR: PHQ-9 score, P=0.018; WAI average score, P=0.010; EORTC-QLQ C30, nine sub-domains, P<0.05; GSRS average score, P= 0.006) and MIS (MIS vs. open surgery: EORTC-QLQ C30, three sub-domains, P<0.05; GSRS average score, P=0.006) were the most significant factors predicting improved GIF and reduced mental stress.

Conclusions:

This study systematically presents postoperative GIF and mental stress of SPN patients using validated multi-questionnaires for the first time. It provides solid evidence that LR and MIS can improve GIF and reduce mental stress after surgery for SPN patients, which could be helpful for the surgeons to make more personalized surgical plans for their patients.
A high risk of postoperative periprosthetic femoral fracture in Dorr type C femurs: a retrospective cohort study with ten-year follow-up data and a preliminary monochromatic image analysis
Authors: Li Mingyang , Zeng Yi , Nie Yong , Liao Kai , Pei Fuxing , Yang Jing , Xie Huiqi , Shen Bin
Published: October 2023

Background:

We applied Anatomique Benoist Girard II (ABG II) stems for total hip arthroplasty (THA) in some Dorr type C femurs as early attempts. Here, we compared the long-term follow-up results between ABG II stems and the “well-performing” Corail stems and their monochromatic images.

Methods:

Among 3214 primary THA records, 43 short ABG II stems and 67 standard-length Corail stems implanted in Dorr type C femurs were eligible and enrolled in this retrospective cohort study, with a mean follow-up of 10.3 years. Revision rates, Harris hip scores, and radiologic signs were compared. Spectral CT scans from a representative sample were obtained, and monochromatic images were reconstructed. A quantitative method was developed to measure the volume of the gap around stems. Patient-specific finite element analysis was conducted to investigate the strains.

Results:

The revision rate of ABG II stems was significantly higher than that of Corail stems (21% vs. 3%, P<0.05). In the monochromatic images, fewer spot-weld signs (2.15 vs. 3.38, P<0.05) and wider gaps around stems (1.64 cm3 vs. 0.13 cm3, P<0.05) were observed on average in the ABG II group. The mean maximum principal strains of the proximal femurs in the ABG II group were close to the yield strains and significantly larger than those in the Corail group (0.0052 vs. 0.0011, P<0.05).

Conclusions:

There was a high risk of postoperative periprosthetic femoral fracture for ABG II stems in Dorr type C femurs. Monochromatic images provided some insight into the failure mechanism.

Level of Evidence:

III
Impact of antibiotic-coated sutures on surgical site infections: a second-order meta-analysis
Authors: Suleiman Adeiza Shuaibu , Abbass Mortada , Hossain Maqsud , Choudhary Priyanka , Bhattacharya Prosun , Islam Md. Aminul
Published: October 2023

Background:

Surgical site infections (SSIs) pose a global challenge, impacting patients and healthcare expenditures. This second-order meta-analysis endeavors to assess the efficacy of antibiotic sutures in averting SSIs by amalgamating data from various meta-studies.

Materials and Methods

This research adhered to the PRISMA 2020 guidelines. The quality and comprehensiveness of the encompassed meta-analyses were assessed through the QUOROM checklist and AMSTAR techniques. The primary study overlap was evaluated via measures such as pairwise intersection heat maps, Corrected Covered Area (CCA), and the citation matrix of evidence. The statistical power at the study level was determined utilizing the meta-meta package. Data synthesis employed random and fixed effects models at a 95% confidence interval. A meta-regression analysis was conducted to explore potential correlations between the CDC classification of surgical site infections, trial types, and the observed effect sizes in the studies.

Results

This investigation revealed a significant reduction in SSI rates due to antimicrobial-coated sutures, evidenced by a relative risk (RR) of 0.68 (95% CI: 0.59 to 0.76), with a prediction interval of 0.38 to 1.19. The analysis encompassed 18 studies with 22 meta-analyses, demonstrating a median QUOROM score of 13.6 out of 18 and an AMSTAR score of 9.1 out of 11. The presence of moderate heterogeneity was noted (Q=106.611, I square=54.038%), with non-randomized controlled trials (RCTs) exhibiting an RR of 0.56 (95% CI: 0.39 to 0.80), and RCTs displaying an RR of 0.71 (95% CI: 0.63 to 0.81). Subgroup analysis unveiled variable RR reductions for specific surgical procedures.

Conclusion

Antimicrobial-coated sutures offer a promising approach to mitigating surgical site infection risk (SSIs). However, their efficacy is optimally realized when employed in conjunction with other robust practices.
Interprofessional Team Members' Knowledge and Perceptions of Physical Therapist Education and Practice
Authors: Hintz Emma G. , Tisthammer Alyson P. , North Sara E.
Published: October 2023

Introduction.

High-quality patient care requires that providers understand and optimize each health care team member's roles and responsibilities.

Review of Literature.

The purpose of this paper was to examine the contemporary knowledge and perceptions of physical therapist (PT) practice and education held by advanced practice interprofessional (IP) team members, including physicians, physician assistants (PAs), and advanced practice registered nurses (APRNs).

Subjects.

Physicians, PAs, and APRNs licensed in the state of Minnesota.

Methods.

Eligible individuals were invited to participate in an online survey assessing understanding of PT practice and education. Descriptive and nonparametric statistical analyses were used to evaluate respondent demographics, practice characteristics, and perceptions and knowledge of PT education and practice.

Results.

Survey responses were analyzed from 442 respondents including 210 APRNs, 182 physicians, 48 PAs, and 2 clinicians of unknown profession. Results demonstrated that most referring providers did not learn about physical therapy during their academic or posttraining education. Those who interacted with PTs more frequently perceived greater benefit for their patients, tended to refer to PTs more often, and demonstrated greater knowledge of PT practice. Poorly understood areas of PT practice and education included PT practice settings, specialties, salary, level of education, and the ability to see patients through direct access.

Discussion and Conclusion.

Multiple areas of poor provider knowledge regarding PT education and practice were identified; many unchanged from the literature in the 1980s. Three main areas of growth were identified from which actionable recommendations are made: increase IP interactions with PTs, address areas of poor understanding of PT education and scope, and maximize shifting perceptions of PTs through education and advocacy. This paper illustrates that PT education and practice are not well understood by referring providers, posing a threat to IP collaboration. A lack of collaboration may hinder patient and system outcomes because of suboptimal provider utilization.
Left Atrial Decompression With the HeartMate3 in Heart Failure With Preserved Ejection Fraction: Virtual Fitting and Hemodynamic Analysis
Authors: He Xiangyu , Bender Moritz , Gross Christoph , Narayanaswamy Krishnaraj , Laufer Günther , Jakubek Stefan , Bonderman Diana , Roehrich Michael , Karner Barbara , Zimpfer Daniel , Granegger Marcus
Published: October 2023

Effective treatment of heart failure with preserved ejection fraction (HFpEF) remains an unmet medical need. Although left atrial decompression using mechanical circulatory support devices was previously suggested, the heterogeneous HFpEF population and the lack of tailored devices have prevented the translation into clinical practice. This study aimed to evaluate the feasibility of left atrial decompression in HFpEF patients with a HeartMate 3 (HM3, Abbott Inc, Chicago, USA) in silico and in vitro. Anatomic compatibility of the HM3 pump was assessed by virtual device implantation into the left atrium through the left atrial appendage (LAA) and left atrial posterior wall (LAPW) of 10 HFpEF patients. Further, the efficacy of left atrial decompression was investigated experimentally in a hybrid mock loop, replicating the hemodynamics of an HFpEF phenotype at rest and exercise conditions. Virtual implantation without substantial intersection with surrounding tissues was accomplished through the LAA in 90% and 100% through the LAPW. Hemodynamic analysis in resting conditions demonstrated normalization of left atrial pressures without backflow at a pump speed of around 5400 rpm, whereas a range of 6400–7400 rpm was required during exercise. Therefore, left atrial decompression with the HM3 may be feasible in terms of anatomic compatibility and hemodynamic efficacy.
Diagnosis and treatment of coagulopathy using thromboelastography with platelet mapping is associated with decreased risk of pulmonary failure in COVID-19 patients
Authors: Hranjec Tjasa , Mayhew Mackenzie , Rogers Bradley , Solomon Rachele , Hurst Deborah , Estreicher Michael , Augusten Alberto , Nunez Aaron , Green Melissa , Malhotra Shivali , Katz Randy , Rosenthal Andrew , Hennessy Sara , Pepe Paul , Sawyer Robert , Arenas Juan
Published: October 2023

Introduction

Treatment of coronavirus disease 2019 (COVID-19) patients may require antithrombotic and/or anti-inflammatory medications. We hypothesized that individualized anticoagulant (AC) management, based on diagnosis of coagulopathy using thromboelastography with platelet mapping (TEG-PM), would decrease the frequency of pulmonary failure (PF) requiring mechanical ventilation (MV), mitigate thrombotic and hemorrhagic events, and, in-turn, reduce mortality.

Methods

Hospital-admitted COVID-19 patients, age 18 or older, with escalating oxygen requirements were included. Prospective and supplemental retrospective chart reviews were conducted during a 2-month period. Patients were stratified into two groups based on clinician-administered AC treatment: TEG-PM guided vs. non-TEG guided.

Results

Highly-elevated inflammatory markers (D-dimer, C-reactive protein, ferritin) were associated with poor prognosis but did not distinguish coagulopathic from noncoagulopathic patients. TEG-guided AC treatment was used in 145 patients vs. 227 treated without TEG-PM guidance. When managed by TEG-PM, patients had decreased frequency of PF requiring MV (45/145 [31%] vs. 152/227 [66.9%], P < 0.0001), fewer thrombotic events (2[1.4%] vs. 39[17.2%], P = 0.0019) and fewer hemorrhagic events (6[4.1%] vs. 24[10.7%],P = 0.0240), and had markedly reduced mortality (43[29.7%] vs. 142[62.6%], P < 0.0001). Platelet hyperactivity, indicating the need for antiplatelet medications, was identified in 75% of TEG-PM patients. When adjusted for confounders, empiric, indiscriminate AC treatment (not guided by TEG-PM) was shown to be an associated risk factor for PF requiring MV, while TEG-PM guided management was associated with a protective effect (odds ratio = 0.18, 95% confidence interval 0.08–0.4).

Conclusions

Following COVID-19 diagnosis, AC therapies based on diagnosis of coagulopathy using TEG-PM were associated with significantly less respiratory decompensation, fewer thrombotic and hemorrhagic complications, and improved likelihood of survival.
Effects of pocket money on weight status among junior high school students: A longitudinal study in China
Authors: Dong Xiaoyang , Chen Libin , Liu Yi , Zhao Li , Wang Weidong
Published: October 2023

Overweight and obesity among adolescents has become a common public health problem, and both obesity rates and the amount of pocket money among adolescents in China are rising. We investigated to what extent the increase in pocket money could lead to weight gain of junior high school students and how this association may vary by school environment in China. Researchers utilized 3 waves of data from the China Education Panel Survey, a national longitudinal study, to investigate the likelihood of overweight and obesity. The Generalized Estimation Equation was employed to analyze the data. Three Generalized Estimation Equation models were constructed to explore the relationship between pocket money and overweight and obesity in 2 distinct food environments surrounding schools. A total of 8903 individuals (4604 boys and 4299 girls) from the China Education Panel Survey were analyzed. After adjusting for confounding factors, it was found that girls who received 20 to 49 yuan and ≥ 50 yuan per week had a higher risk of overweight and obesity compared to those who received 0 to 9 yuan per week (OR = 1.34, 95% CI: 1.07–1.69, OR = 1.53, 95% CI: 1.22–1.92). However, no significant association was observed between pocket money and overweight and obesity when food around the school was not easily accessible. The prevalence of overweight among Chinese teenagers has steadily increased from Wave1 to Wave3. Moreover, junior high school girls who receive more pocket money are at a greater risk of developing obesity and overweight issues.
Clinicopathological and prognostic values of MET expression in pancreatic adenocarcinoma based on bioinformatics analysis
Authors: Yao Yixing , Zhan Rui , Gong Chanchan , Lv Jiaying , Lu Xialiang
Published: October 2023

Pancreatic adenocarcinoma (PAAD) is regarded as one of the most lethiferous cancers worldwide because treatment of pancreatic cancer remains challenging and mostly palliative. Little progress had been made to select certain reliable biomarkers as clinical prognosis. In this context, GSE28735 and GSE16515 were obtained from the Gene Expression Omnibus (GEO). GEO2R tool was used to recognize differentially expressed genes (DEGs). 351 DEGs were screened which included 230 up-regulated genes and 121 down-regulated genes. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to analyze the DEGs and associated signal pathways in the DAVID database. A protein–protein interaction (PPI) network was then constructed to screen 10 hub genes by STRING database and Cityscape software. Analyses of 10 hub genes were performed on GEPIA database and GSCA database, which revealed that MET was high expressed and significantly associated with survival of PAAD patients. Immunohistochemical staining showed that MET was higher expressed in PAAD tissues than adjacent tissues in 20 samples. The clinicopathological analysis revealed that high expression of MET was associated with the degree of differentiation, lymph node metastasis, vascular cancer thrombus and nerve invasion in PAAD tissues (P < .05). Furthermore, the Tumor Immune Estimation Resource (TIMER) database analyzed the correlation between the MET expression level and immune infiltration levels, which elucidated that MET expression was appreciably positively correlated with the infiltration levels of myeloid-derived suppressor cells (MDSCs). Here, these results strongly indicate MET is an unique prognostic biomarker. Its expression level is correlated with certain clinicopathological features and immune cell infiltration.
Experiences of adults with opioid-treated chronic low back pain during the COVID-19 pandemic: A cross-sectional survey study
Authors: Zgierska Aleksandra E. , Burzinski Cindy A. , Garland Eric L. , Barrett Bruce , Lennon Robert P. , Brown Roger L. , Schiefelbein Anthony R. , Nakamura Yoshio , Stahlman Barbara , Jamison Robert N. , Edwards Robert R.
Published: October 2023

This study aimed to evaluate the impact of the COVID-19 pandemic on adults with opioid-treated chronic low back pain (CLBP), an understudied area. Participants in a “parent” clinical trial of non-pharmacologic treatments for CLBP were invited to complete a one-time survey on the perceived pandemic impact across several CLBP- and opioid therapy-related domains. Participant clinical and other characteristics were derived from the parent study’s data. Descriptive statistics and latent class analysis analyzed quantitative data; qualitative thematic analysis was applied to qualitative data. The survey was completed by 480 respondents from June 2020 to August 2021. The majority reported a negative pandemic impact on their life (84.8%), with worsened enjoyment of life (74.6%), mental health (74.4%), pain (53.8%), pain-coping skills (49.7%), and finances (45.3%). One-fifth (19.4%) of respondents noted increased use of prescribed opioids; at the same time, decreased access to medication and overall healthcare was reported by 11.3% and 61.6% of respondents, respectively. Latent class analysis of the COVID-19 survey responses revealed 2 patterns of pandemic-related impact; those with worse pandemic-associated harms (n = 106) had an overall worse health profile compared to those with a lesser pandemic impact. The pandemic substantially affected all domains of relevant health-related outcomes as well as healthcare access, general wellbeing, and financial stability among adults with opioid-treated CLBP. A more nuanced evaluation revealed a heterogeneity of experiences, underscoring the need for both increased overall support for this population and for an individualized approach to mitigate harms induced by pandemic or similar crises.
Analysis of HPV prevalence among individuals with reproductive tract infections in a Chinese population
Authors: Zhou Yu-Xia , Wang Liang , Wang Ting-Ting , Qu Xiao-Li , Zhang Xiao-Qian
Published: October 2023

The previous research has found that human papillomavirus (HPV) infection is the main cause of cervical cancer, but it is still unclear whether HPV infection, as well as the HPV genotypes, are related to reproductive tract infections in the Chinese population. Patients who underwent HPV screening at Shandong Maternal and Child Health Hospital were selected, and the HPV infection status was analyzed among patients with cervical lesions, bacterial vaginosis, cervical inflammation, fungal vaginitis, and pelvic infections. SPSS 22 statistical analysis was used to analyze the differences in HPV infection types and rates between the control group and the experimental group. The HPV infection rate of bacterial vaginosis (χ2 = 13.4; P < .001) and fungal vaginitis (χ2 = 3.3; P < .045) are both significantly different from the control group. The single HPV infections reveals significant differences from control group in bacterial vaginosis (χ2 = 7.3; P = .004), fungal vaginitis (χ2 = 4.5; P = .023), and cervical lesions (χ2 = 58.8; P < .001). In the bacterial infection group, HPV51 (1.9%; χ2 = 6.0; P = .008) and HPV58 (4.7%; χ2 = 3.3; P = .044) showed significant differences in infection compared to the control group. In the fungal infection group, HPV39 (2.7%; χ2 = 4.7; P = .032) showed a significant difference in infection compared to the control group. Cervical lesions, bacterial vaginosis, fungal vaginitis, and cervical lesions among Chinese population exhibit age-specified distribution. HPV infection rate in bacterial vaginitis, fungal vaginitis and cervical lesions was higher than that in normal group. HPV52 and HPV16 infection are different, and HPV39 is different between bacterial vaginitis and fungal vaginitis.
Evolution of the search for a common mechanism of congenital risk of coronary heart disease and type 2 diabetes mellitus in the chromosomal locus 9p21.3
Authors: Benberin Valeriy , Karabaeva Raushan , Kulmyrzaeva Nazgul , Bigarinova Rauza , Vochshenkova Tamara
Published: October 2023

9.21.3 chromosomal locus predisposes to coronary heart disease (CHD) and type 2 diabetes mellitus (DM2), but their overall pathological mechanism and clinical applicability remain unclear. The review uses publications of the study results of 9.21.3 chromosomal locus in association with CHD and DM2, which are important for changing the focus of clinical practice. The eligibility criteria are full-text articles published in the PubMed database (MEDLINE) up to December 31, 2022. A total of 56 publications were found that met the inclusion criteria. Using the examples of the progressive stages in understanding the role of the chromosomal locus 9p.21.3, scientific ideas were grouped, from a fragmentary study of independent pathological processes to a systematic study of the overall development of CHD and DM2. The presented review can become a source of new scientific hypotheses for further studies, the results of which can determine the general mechanism of the congenital risk of CHD and DM2 and change the focus of clinical practice.
Bioinformatics analysis of competing endogenous RNA network in decidual natural killer cell from unexplained recurrent spontaneous abortion
Authors: Han Dan , Jia Ningyi
Published: October 2023

Background:

Decidual natural killer (dNK) cell plays a pivotal role in maintaining pregnancy, especially in the first trimester. Noncoding-RNAs (ncRNAs) are critical regulators of transcription and protein expression. Dysregulation of ncRNAs may be involved in the pathogenesis of unexplained recurrent spontaneous abortion (URSA). However, the role of competing endogenous RNA (ceRNA) based on mRNA–miRNA–lncRNA network in regulating the incidence and progression of URSA remains elusive. The aim of the study is to identify the regulatory network of mRNA–miRNA–LncRNA ceRNA based on bioinformatics analysis in dNK from patients with URSA.

Methods:

Eligible studies were retrieved from PubMed, Embase, and the Gene Expression Omnibus (GEO) databases to identify differentially expressed genes (DEGs), miRNAs and LncRNAs in dNK cells of patients with URSA. Protein–protein interaction (PPI) network was constructed by STRING database and Cytoscape software. Potential regulatory miRNAs and lncRNAs of mRNAs were predicted by miRTarBase and RNA22 and subject to bioinformatics analysis.

Results:

A total of 634 DEGs were screened, including 290 upregulated and 344 downregulated DEGs. Among 207 differentially expressed lncRNAs, 110 lncRNAs were upregulated and 97 were downregulated. According to node degree, 30 hub genes were identified for subsequent research. After drawing the Venn diagram and matching to Cytoscape, an mRNA–miRNA–lncRNA network linked to the pathogenesis of URSA in dNK cells was constructed.

Conclusions:

A novel regulatory network of mRNA–miRNA–lncRNA ceRNA is established in dNK cells from patients with URSA. All RNAs might be used as the biomarkers of the pathogenesis of URSA.
Comparing the effectiveness of single-lumen high-frequency positive pressure ventilation with double-lumen endobronchial tube for the anesthesia management of endoscopic thoracic sympathetic blockade surgery
Authors: Akaslan İlhan , Koc Suna
Published: October 2023

Objectives:

In this trial, we aimed to compare anesthetic effectiveness of single lumen tube (SLT) for tracheal intubation with high-frequency positive pressure ventilation (HFPPV) versus classic double lumen tube (DLT) for tracheal intubation in endoscopic thoracic sympathetic blockade surgery.

Design:

This was a prospective randomized controlled clinical study.

Setting:

The study was single-centered and conducted in a university hospital.

Participants:

There were 135 endoscopic thoracic sympathetic blockade patients in this study.

Interventions:

The patients were randomly allocated either to DLT (n = 67) or SLT (n = 68) groups. In SLT group, the ventilator setting was kept with frequencies that range from 1 to 1.8 Hz (60–110/min). Data regarding anesthesia duration, surgery duration, difficult intraoperative lung deflation, postoperative atelectasis, postoperative pain, postoperative pneumothorax were recorded and compared. All patients were operated by a single experienced surgeon under general anesthesia provided by the same anesthesia team.

Measurements and main results:

Both groups were age and gender matched. Among all recorded variables, only anesthesia time was found to be close to statistical significance (P = .059, favoring single lumen). All other parameters were found to be similar between groups. (P < .05).

Conclusion:

We reported that DLT and single lumen tracheal intubation were equally effective for lung deflation during surgery, and SLT with HFPPV ventilation mode during endoscopic thoracic sympathetic blockade surgery provided the surgeon with an adequate and clean workspace with shorter onset of anesthesia. We may suggest the HFPPV technique for uncomplicated surgery groups or where sufficient conditions for DLT cannot be provided in the operating room.
Efficacy and safety of Chinese patent medicine compound preparation combined with routine treatment in vitiligo: A Bayesian network meta-analysis
Authors: Wang Jianfeng , Wang Dingding , Si Guomin
Published: October 2023

Background and purpose:

Treating vitiligo in clinical practice is challenging. Furthermore, oral drugs used in Western medicine have considerable side effects and are unsuitable for long-term treatment. In contrast, Chinese patent medicines (CPMs) are more suitable for long-term oral vitiligo treatment, but medical evidence of their efficacy and safety is lacking. Therefore, in this study, the efficacy and safety of CPMs were evaluated and ranked using a Bayesian network meta-analysis.

Methods:

Seven Chinese and English databases were searched for all relevant articles published up to February 2023. The Bayesian network meta-analysis method was used to analyze the extracted data to evaluate efficacy and safety.

Results:

Six common CPMs for treating vitiligo were selected in our study, and 48 targeted articles and 4446 patients were included. This study showed that Qubai Babuqi tablets (QT) were the most effective for short-term treatment of vitiligo, and that vitiligo capsules or pills (VCP) were the most effective for long-term treatment, together with compound Quchong Banjiuju pills (QP). In terms of surface area under the cumulative ranking curve (SUCRA) values, the order of efficacy of each treatment was as follows: QT (92.18%) > Taohong Qingxue pills (TP) (63.81%) > VCP (55.53%) > QP (50.72%) > Bailing tablets or capsules (BTC) (49.01%) > Baishi pills (BP) (35.69%)>routine therapy (RT) (3.1%) in terms of total effective rate and QT (92.05%) > VCP (71.50%) > QP (66.60%) > TP (42.95%) > BTC (39.66%) > BP (36.60%)>RT (0.6%) in terms of improvement rate. In addition, the safety of the 6 CPMs did not significantly differ in terms of adverse effects. The SUCRA values indicated that QT performed slightly worse than other drugs.

Discussion:

In treating vitiligo, QT is most effective but only suitable for short-term administration owing to its poor safety. VCP and QP could be used as first-choice long-term medications. TP may positively affect repigmentation in patients with limited lesion areas.
Evaluating the potential of matrix metalloproteinase as a diagnostic biomarker in rheumatoid arthritis and periodontitis: A systematic review and meta-analysis
Authors: Batool Aimen , Vaithilingam Rathna Devi , Mohamad Hassan Norul Husna , Safii Syarida Hasnur , Saub Roslan
Published: October 2023

Background:

Matrix metalloproteinases (MMPs) play a crucial role in the pathogenesis of several chronic diseases including rheumatoid arthritis (RA) and periodontitis (PD). RA patients with periodontitis (RA-PD) are associated with elevated inflammatory burden due to increased production of proinflammatory cytokines. Controlling upregulated MMPs activity in these patients may have potential therapeutic effects. Therefore, aim of this study is to address the focused question: “Do RA subjects with concurrent PD have different levels of MMPs in comparison to RA alone, PD alone and HC subjects?”

Methods:

The systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search from 4 electronic databases (EMBASE, Medline, Web of Science, and Cochrane library) and manual search was performed from inception to July 2023. Quality assessment of each article was done using Newcastle-Ottawa Scale. Meta-analyses derived results were summarized as standardized mean difference (SMD) with 95% confidence intervals.

Results:

A total of 879 articles were extracted. Following screening and full text assessment, 9 studies were included. MMP-1, MMP-3, MMP-8, MMP-9, and MMP-13 were consistently elevated in RA-PD subjects. MMP-8 levels were found to be higher in RA-PD subjects compared with RA alone, PD alone, and HC in 3 studies reporting GCF levels (SMD = 1.2; Z = 2.07; P = .04) and 2 studies reporting serum levels (SMD = 0.87; Z = 4.53; P < .00001).

Conclusion:

RA-PD group showed significantly higher MMP levels in their serum and GCF compared with HC, RA, and PD alone individuals. MMP-8 may serve as a reliable biomarker in the diagnosis and management of RA-PD subjects.
Effects of information-knowledge-attitude-practice health education combined with cluster-based care in patients with gestational hypertension
Authors: Wen Jiao , Liu Xiuping
Published: October 2023

To analyze the impact of information-knowledge-attitude-practice (IKAP) health education incorporated with cluster-based care on blood pressure control, pregnancy outcome and life quality in those who have gestational hypertension, and to provide methodological backing for the care of patients. A total of 80 patients with pregnancy-induced hypertension were selected as the research objects and randomly divided into control and experimental groups, with 40 cases in each group. The control group received routine cluster care, which included providing individual and group health information through the distribution of health education manuals to hypertensive patients during pregnancy and their families. The experimental group received additional IKAP health education, including data collection, health knowledge imparted, concept change and behavior generation process. Blood pressure control status was measured and recorded. Adverse pregnancy outcomes include placenta previa, cesarean section, hyperamniotic fluid, fetal distress, and postpartum hemorrhage. Postpartum quality of life conditions, including physical activity, emotional awareness, physical discomfort, mental health, sleep quality, postpartum anxiety or depression, and general health were evaluated. Age, prepregnancy BMI, and educational level did not significantly vary between the 2 groups(P > .05). In comparison to the control group, the experimental group demonstrated healthier behavior. Blood pressure and weight control during pregnancy were better than control group. The frequency of adverse pregnancy was inferior to control group. The number of adverse neonatal conditions was inferior to control group. The postpartum quality of life score was higher in the experimental group compared to the control group. The combination of IKAP health education and cluster based care has a better effect on blood pressure control compared to the sole use of cluster based care. This approach can reduce the likelihood of experiencing adverse pregnancy outcomes and help improve the quality of life for patients after delivery.
A case report of systemic lupus erythematosus and intestinal tuberculosis with lower gastrointestinal bleeding: A treatment approach utilizing parenteral nutrition
Authors: Zhou Aiping , Wang Ying , Chen Yanling , Zhong Hua , Chen Bo , Tan Chunyu
Published: October 2023

Rationale:

Limited literatures are available on lower gastrointestinal bleeding in systemic lupus erythematosus (SLE) combined with intestinal tuberculosis. Sharing the treatment experiences of a 26-year-old female patient diagnosed with this complex condition in this report may contribute valuable insights.

Patient concerns:

The patient initially presented with abdominal pain and active gastrointestinal bleeding, leading to admission to the hospital. Over a 2-week period, she experienced persistent bleeding, with daily volumes ranging from 300 mL to 800 mL.

Diagnoses:

Lower gastrointestinal bleeding was diagnosed in this patient with concurrent systemic lupus erythematosus and intestinal tuberculosis.

Interventions:

As her symptoms rapidly progressed, food and water intake had to be completely restricted. The parenteral nutrition was implemented.

Outcomes:

The medical team effectively controlled the bleeding, leading to a notable improvement in the patient’s condition. Consequently, she was able to resume oral intake and was discharged from the hospital.

Lessons:

This case highlights the significance of using parenteral nutrition in the management of lower gastrointestinal bleeding in patients with concurrent systemic lupus erythematosus and intestinal tuberculosis. Close monitoring and collaborative efforts among healthcare professionals are crucial to achieve successful outcomes in similar cases.
Network pharmacology-based strategy for predicting therapy targets of Ecliptae Herba on breast cancer
Authors: Li Hui , Shi Wei , Shen Tingming , Hui Siwen , Hou Manting , Wei Ziying , Qin Shuanglin , Bai Zhaofang , Cao Junling
Published: October 2023

Breast cancer is a prevalent malignancy affecting women globally, characterized by significant morbidity and mortality rates. Ecliptae Herba is a traditional herbal medicine commonly used in clinical practice, has recently been found to possess antitumor properties. In order to explore the underlying material basis and molecular mechanisms responsible for the anti-breast cancer effects of Ecliptae Herba, we used network pharmacology and experimental verification. UPLC-MS/MS was utilized to identify compounds present in Ecliptae Herba. The active components of Ecliptae Herba and its breast cancer targets were screened using public databases. Hub genes were identified using the STRING and Metascape database. The R software was utilized for visual analysis of GO and KEGG pathways. The affinity of the hub targets for the active ingredients was assessed by molecular docking analysis, which was verified by experimental assessment. A total of 178 targets were obtained from the 10 active components of Ecliptae Herba, while 3431 targets associated with breast cancer were screened. There were 144 intersecting targets between the components and the disease. Targets with a higher degree, namely EGFR and TGFB1, were identified through the hub subnetwork of PPI. GO and KEGG analyses revealed that Ecliptae Herba plays an important role in multiple cancer therapeutic mechanisms. Moreover, molecular docking results showed that the core components had good binding affinity with key targets. Finally, it was confirmed that TGF-β1 might be a potential crucial target of Ecliptae Herba in the treatment of breast cancer by cytological experiments, and the TGF-β1/Smad signaling pathway might be an important pathway for Ecliptae Herba to exert its therapeutic effects. This study elucidated the active ingredients, key targets, and molecular mechanisms of Ecliptae Herba in the treatment of breast cancer, providing a scientific foundation and therapeutic mechanism for the prevention and treatment of breast cancer with Traditional Chinese medicine.
Nutritional intervention for the prognosis of nasopharyngeal carcinoma chemoradiotherapy patients: A meta-analysis
Authors: He Ying , Chen Xiaoyu , Yang Tong , Li Yan , Tan Sitao , Liu Xiaoxia
Published: October 2023

Background:

To conduct a meta-analysis to investigate the effects of different nutritional interventions on various serum nutritional indicators and patients’ prognosis during radiotherapy for nasopharyngeal carcinoma, to assess treatment safety and efficacy.

Methods:

A systematic literature search, mainly randomized controlled trials (RCTs), on the effects of nutritional support on patients undergoing radiotherapy for nasopharyngeal carcinoma was conducted between January 2010 and August 2022 using databases such as China National Knowledge Infrastructure, Wanfang Database, Web of Science, PubMed, Cochrane Library, and Embase. Risk of bias was assessed using the Cochrane Rob2 scale. The meta-analysis was performed using Stata 17.0 software, and the heterogeneity between studies was assessed using the I2 test, and funnel plots were used to qualitatively assess publication bias.

Results:

Overall, 10 RCTs with a total sample size of 879 cases were identified. The meta-analysis results showed that body mass index (BMI) (odds ratio = 0.026, 95% confidence interval[1]: −0.348 to 0.401, P > .05), albumin (standardized mean difference [SMD] = 0.13, 95% CI: −0.127 to 0.387, P > .05), and total protein levels were not significantly different between the nasopharyngeal cancer (NPC) radiotherapy group with nutritional support group (SMD = −0.262, 95% CI: −1.062 to 0.537, P > .05) and the control group; pre-albumin (SMD = 0.256, 95% CI: 0.022–0.491, P = .032), hemoglobin (SMD = 0.436, 95% CI: 0.26–0.612, P < .000), and lymphocyte count (SMD = 1.125, 95% CI: 0.868–1.381, P < .000) were significantly higher in the nutritional intervention group than in the control group.

Conclusion:

Compared with conventional diets, nutritional interventions can improve serum nutritional parameters, nutritional status, treatment tolerance, and prognosis of patients undergoing radiotherapy for nasopharyngeal carcinoma.
Short limb in biliary tract reconstruction: A retrospective study of living donor liver transplantation in children with biliary atresia
Authors: Zhang Yuhong , Zhu Zhijun
Published: October 2023

Roux-en-Y cholangiojejunostomy is a standard procedure for biliary reconstruction in pediatric living donor liver transplantation (LDLT). However, there is uncertainty on whether the adult standard of Roux branch limb is suitable for pediatric LDLT and its impact on postoperative biliary complications (BC). This study aimed to explore the effect of the short Roux limb and standard limb on pediatric LDLT biliary reconstruction. According to the length of the Roux limb, 168 LDLT children were divided into the routine limb group (n = 108) and the short limb group (n = 60). The incidences of postoperative biliary tract complications between the 2 groups were compared retrospectively. The mean Roux limb length in the short limb group was significantly shorter than that in the routine limb group group (P < .01). There were significant differences in age, height, and weight between the 2 groups (P < .01). However, there were no significant differences in graft-to-recipient weight ratio, intraoperative blood loss, cold ischemia time, and operation time between the 2 groups (P > .01). Moreover, postoperative BC, including refluxing cholangitis, were similar between the 2 groups (P = .876). Furthermore, the history of Kasai surgery, the history of postoperative RC of Kasai, and whether or not the Roux limb was reconstructed had no significant effect on the occurrence of postoperative RC. There was no significant difference in postoperative BC between the short limb and the routine limb in children with living donor liver transplantation.
Understanding multi-level barriers to medication adherence among adults living with sickle cell disease
Authors: Egiebor Ivie C. , McCleary Karl J. , Banta Jim E. , Mataya Ronald , Shih Wendy
Published: October 2023

There is limited research that identifies and examines multi-level barriers to medication adherence among adults with Sickle Cell Disease (SCD); Identify multi-level barriers to medication adherence among adults with SCD; and Examine the relationship between multi-level barriers and medication adherence levels. A cross-sectional study included 130 adults (ages ≥ 18 years old) living with SCD who receive treatment/care from one of the 10 adult SCD clinics within the Networking California for sickle cell care initiative. Study measures included the medication adherence report scale (Professor Rob Horne), Beliefs about Medicine Questionnaire (Professor Rob Horne), and patient reported outcomes measurement information system. Participants reported barriers to medication adherence across 3 levels: Community-level barriers (e.g., COVID-19 pandemic); Institutional-level barriers (e.g., bad experiences with the health care system); and Individual-level barriers (e.g., beliefs and depression severity). Depression severity and patient concerns about SCD medication were inversely correlated with medication adherence (rs = −0.302, P < .001; rs = −0.341, P < .001 respectively). Patient beliefs about the necessity of SCD medication were insignificantly correlated with medication adherence (rs = 0.065, P = .464). Medication adherence was higher among patients who had fewer adherence barriers than multiple adherence barriers (Median medication adherence: fewer barriers = 22 vs multiple barrier = 20.50, P = .085), suggesting clinical significance although statistically insignificant. Identifying multi-level adherence barriers and examining their relationship with medication adherence will help develop targeted public health strategies to promote improved medication adherence and wellness among adults with SCD.