bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the safety of remimazolam and propofol during general anesthesia in elderly patients: systematic review and meta-analysis
Authors: Liu Xianchun , Zhang Longyi , Zhao Li , Zhou Xuelei , Mao Wei , Chen Linlin , Zhu Hongyu , Xie Ying , Li Linji 
Published: February 2025

BackgroundRemimazolam is a novel sedative drug approved for procedural sedation and general anesthesia. Clinical trials have already explored its use in elderly patients for general anesthesia. For elderly patients with declining physical and physiological function, anesthesia safety is crucial. Most current clinical studies compare the safety of remimazolam and propofol, though the results are inconsistent. Therefore, we conducted a meta-analysis to compare the safety of remimazolam and propofol in general anesthesia for elderly patients.MethodsWe systematically searched the PubMed, Cochrane Library, Embase, and Web of Science databases for all published randomized controlled trials comparing remimazolam and propofol for general anesthesia in elderly patients. We synthesized data from eligible studies using relative risk or mean difference, and analyzed differences in hemodynamic stability and adverse effects between the two drugs. Data extraction and quality assessment were performed independently by two researchers.ResultsEight randomized controlled trials involving 571 participants were included. Compared to propofol, remimazolam was associated with a lower incidence of hypotension (RR = 0.51, 95% CI: [0.33, 0.81], I2 = 18%, p = 0.3 &gt; 0.1) and bradycardia (RR = 0.56, 95% CI: [0.31, 1.02], Z = 1.88, p = 0.06 &lt; 0.05). The mean arterial pressure after induction was higher in the remimazolam group (WMD = 3.95, 95% CI: [3.197, 9.498], Z = 3.95, p &lt; 0.00001). The remimazolam group had a higher heart rate (HR) after induction compared to the propofol group (WMD = 7.89, 95% CI: [−2.39, 18.17], Z = 1.5, p = 0.13 &gt; 0.05), but this result was not statistically significant. Among other secondary outcomes, the remimazolam group had lower incidences of injection site pain, nausea and vomiting, and hypoxemia compared to the propofol group, and also had a shorter extubation time.ConclusionIn this meta-analysis, compared to propofol, remimazolam reduced the incidence of hypotension, bradycardia, and injection site pain during general anesthesia in elderly patients. The mean arterial pressure (MAP) and heart rate (HR) were more stable after induction. Remimazolam may be a safer sedative for elderly patients.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024516950, CRD42024516950.
Risk factors for ocular biological parameters in Chinese preschool children: a cohort study from the Beijing whole childhood eye study
Authors: Qin Xi , Sun Yunyun , Wang Shana , Xie Xiaolan , Gao Lei , Li Huijian , Wei Ruihua , Fu Jing , Zhu Bidan 
Published: February 2025

BackgroundThe high myopia prevalence in young East Asian children necessitates early detection and prevention strategies. Axial length (AL), corneal radius of curvature (CR), and the AL to CR ratio (AL/CR) are potential myopia biomarkers. However, the influence of genetic, growth and development, and environmental factors on these metrics in Chinese preschool children remains unclear. Therefore, this study aimed to investigate the effects of these factors on the AL, CR, and AL/CR ratio in children aged 3–6 years in Beijing.MethodsIn this 3-month study, initiated in November 2021, children aged 3–6 years from nine kindergartens in Beijing were randomly selected for ocular biological parameter measurements. The height and weight of each child were measured, and their parents completed a questionnaire on parental myopia and environmental influences. The AL/CR ratio were calculated. One-way analysis of variance, univariate analysis, and multiple linear regression models (with age, sex, height, weight, parental myopia, continuous near-work time, electronic products use, and outdoor activity time as variables) were used to compare the effects of different variables on the AL, CR, and AL/CR ratio.ResultsOverall, 1,353 participants (708 boys; mean age, 4.37 ± 0.82 years) were included in this study. The multiple linear regression analysis revealed that parental myopia significantly increased the AL and AL/CR ratio (p = 0.002, p &lt; 0.001). Male participants had a longer AL, larger CR, and greater AL/CR ratio than female participants (all p &lt; 0.001). A longer AL and larger CR were associated with greater height (both p &lt; 0.001). The AL/CR ratio increased with age (p &lt; 0.001). The CR was positively associated with the amount of time spent outdoors (p = 0.004).ConclusionOcular biological parameters are influenced by genetic, growth and development, and environmental factors. Among children aged 3–6 years in Beijing, monitoring growth and development, investigating parental myopia, and evaluating eye habits have certain guiding significance for delaying increases in the AL and AL/CR ratio. This study may provide some suggestions for the development of healthy eye habits.
Factors influencing sleep disorders in perimenopausal women: a systematic review and meta-analysis
Authors: Zeng Weisi , Xu Jialan , Yang Ying , Lv Meiling , Chu Xin 
Published: February 2025

BackgroundTo determine the influencing factors of sleep disorders in perimenopausal women by Meta-analysis.MethodsA comprehensive literature search was conducted by PubMed, Embase, CINAHL, and Web of Science(from inception to December 1,2023). Two researchers independently performed literature screening, quality evaluation and data extraction, and Stata16.0 software were used for Meta-analysis.ResultsA total of 12 studies involving 11,928 perimenopausal women with sleep disorders were included. The results of Meta-analysis showed that depression(OR = 2.73, 95%CI 1.65 ~ 4.52), hot flashes (OR = 2.70, 95%CI 1.81 ~ 4.02), chronic disease (OR = 1.39, 95%CI 1.24 ~ 1.56) and psychotropic drug use(OR = 3.19, 95%CI 1.31 ~ 7.77) were risk factors for sleep disorders in perimenopausal women (p &lt; 0.05).ConclusionSleep disorder is one of the most common symptoms in perimenopausal women, and its influencing factors should be paid attention to. Healthcare managers can further improve and standardize the prevention and management of sleep disorders in perimenopausal women according to the influencing factors, accurately identify high-risk groups, implement intervention measures, and reduce the severity and incidence of sleep disorders in perimenopausal women.
Individualized prediction of stroke-associated pneumonia for patients with acute ischemic stroke
Authors: Zhang Lulu , Wang Qi , Li Yidan , Fang Qi , Tang Xiang 
Published: February 2025

BackgroundStroke-associated pneumonia (SAP) remains a neglected area despite its high morbidity and mortality. We aimed to establish an easy-to-use model for predicting SAP.MethodsTwo hundred seventy-five acute ischemic stroke (AIS) patients were enrolled, and 73 (26.55%) patients were diagnosed with SAP. T-test, Chi-square test and Fisher’s exact test were used to investigate the associations of patient characteristics with pneumonia and its severity, and multivariable logistic regression models were used to construct a prediction scale.ResultsThree variables with the most significant associations, including age, NGT placement, and right cerebral hemisphere lesions combined with gender, were used to construct a stroke-associated pneumonia prediction scale with high accuracy (AUC = 0.93). Youden index of our SAP prediction model was 0.77. The sensitivity and specificity of our SAP prediction model were 0.89 and 0.88, respectively.ConclusionWe identified the best predictive model for SAP in AIS patients. Our study aimed to be as clinically relevant as possible, focusing on features that are routinely available. The contribution of selected variables is visually displayed through SHapley Additive exPlanations (SHAP). Our model can help to distinguish AIS patients of high-risk, provide specific management, reduce healthcare costs and prevent life-threatening complications and even death.
Association between the expression of specific microRNAs and prostate cancer progression- a systematic review and meta-analysis
Authors: Alrehaili Jihad Awadallah 
Published: February 2025

BackgroundThis systematic review and metanalysis aimed to summarize the evidence supporting the significance of particular MiRNAs in PrCa progression and to thoroughly examine the body of prior research.MethodsIn accordance with the PRISMA guidelines, this review was conducted using a specifically design data extraction protocol and searching several online databases for relevant articles. The protocol was registered in the PROSPERO database (CRD42023428460).Results8 studies were ultimately included in this review. MiRNAs significantly reduced PrCa proliferation, with an odds ratio (OR) of 0.28 (95% CI: 0.21–0.39) and a risk ratio (RR) of 0.51 (95% CI: 0.43–0.61), though moderate heterogeneity was observed (I² = 57%). For two studies investigating MiRNAs as biomarkers for predicting metastasis, the pooled OR was 0.60 (95% CI: 0.47–0.76) and the RR was 0.72 (95% CI: 0.62–0.84), both demonstrating significant predictive value with low heterogeneity (I² = 0%).ConclusionThe results emphasize the potential of miRNAs as biomarkers for predicting PrCa metastasis and demonstrate that miRNAs have a discernible effect on PrCa proliferation. However, to improve our comprehension of MiRNA’s function in this condition, additional studies are required to address the limitations and investigate how MiRNA acts in many areas of PrCa.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023428460.
Self-selected vs. prescribed aerobic exercise intensity: impacts on pleasure in women with obesity
Authors: Da Silva Carlos Eduardo Rosa , Santana Wilian Jesus , Almeida Gustavo , Verame Adriano , Doro Antonio Roberto , Barbosa Eduardo , Lima Leonardo , Dias Helton Magalhães , Zanetti Marcelo Callegari , Junior Aylton Figueira 
Published: February 2025

IntroductionSelf-selection of aerobic training intensity is an approach that allows practitioners to develop autonomy (choice of pace), improve physical fitness, and contribute to better affective responses and training adherence. However, it is still unclear whether self-selection of training intensity in group settings is comparable to individual training conditions. The aim of the present study was to compare the effect of three aerobic training protocols on psychophysiological responses in physically inactive adult obese women.MethodsThe sample consisted of 90 women with a mean age of 48.3 ± 5.5 years and BMI of 31.2 ± 4.8 kg/m2, who participated in three treadmill aerobic training protocols: 1- Control group (IPI) with individually prescribed intensity (64 to 76% of HRmax), 2- Small group (SGS) with self-selected intensity, and 3- Individual with self-selected intensity (ISS). Heart rate (HR), total session volume (VL), affective valence was determined by feeling scale (FS), enjoyment was determined by Physical Activity Enjoyment Scale (PACES), intention to repeat the exercise session (INT), and Basic Psychological Needs Satisfaction Scale (BPNFS) were evaluated. Statistical analyses were conducted using two-way ANOVA for HR and FS, and one-way ANOVA for VL, PACES, INT, and BPNFS with Tukey post hoc test and significance criteria (p &lt; 0.05).ResultsThe results showed that HR and VL were similar (p &gt; 0.05) between the protocols IPI, SGS and ISS, while FS, PACES, and INT were significantly higher in SGS and ISS than IPI protocols (p &lt; 0.05). BPNFS also presented better results for the SGS and ISS protocols (p &lt; 0.05).DiscussionThese findings suggest that the intensity and training volume were similar among different protocols. Affective responses were more positive perceived in SGS and ISS protocols.ConclusionWe conclude that intensity self-selection is a safe, effective, and comparable strategy to prescribed intensity at moderate levels, providing a more enjoyable experience that may contribute to greater adherence to aerobic training.
Pastoral livestock farming constraints and adaptation strategies in response to institutional reforms in the Sudano-Sahelian zone of West Africa
Authors: Ilboudo Basnewindé , Zaré Alhassane , Traoré Innocent Charles Emmanuel , Bondé Loyapin , Guuroh Reginald Tang , Ouédraogo Oumarou 
Published: February 2025

IntroductionLivestock farming is one of the main socio-economic activities in West Africa, predominantly extensive and reliant on natural rangelands. In Burkina Faso, the pastoral zone creation process began in 1980 to sedentarize livestock farmers, reduce social conflict, and strengthen livestock production. Therefore, these areas were subjected to institutional reforms with direct consequences on pastoralism. This study aimed to analyze the effects of land tenure and protected area governance reforms on the pastoral production system by identifying concomitantly related constraints and adaptation strategies adopted by local communities.MethodsData were collected through analysis of policy documents, and surveys from 280 key informants and household heads related to the pastoral zone of Yallé using individual interviews and focus group discussions. The main information collected included pastoral landscape and the current state of the livestock production system. Data were also taken on pastoral constraints related to land reforms, protected area governance, and alternative adaptation strategies developed to address constraints.Results and discussionThe changes highlighted are the challenge to the pastoral zone and the appropriation of pastureland by other users inducing range shrinkage, inaccessibility to water resources, and farmer-herders conflicts. In response, some livestock farmers drive their herds out of the country, while others illegally graze in protected areas. They also combine socio-professional conversion to support their livelihoods, with atypical transhumance in the rainy season and seek herd feed satisfaction. New forage harvesting techniques, supported by training, and the integration of agriculture into livestock farming are opportunities to promote agropastoralism, more sustainable. Policymakers should ensure that livestock development actions are legally secure and that institutional reforms promote common resource use in pastoral areas. Also, livestock farmers are encouraged to create community structures for coordinated resource management and conflict resolution. Further, State institutions must supervise investor establishment in pastoral zones while preventing private property rights over the land.
Pharmacokinetics of Snake Antivenom Following Intravenous and Intramuscular Administration in Envenomed Large Animal Model
Authors: Gamulin Erika , Mateljak Lukačević Sanja , Lang Balija Maja , Smajlović Ana , Vnuk Dražen , Gulan Harcet Jadranka , Tomičić Maja , Hećimović Ana , Halassy Beata , Kurtović Tihana 
Published: February 2025

Background: The parenteral administration of antivenoms is the mainstay in snakebite envenoming therapy. The standardized protocol does not exist, but it is agreed that the intravenous (i.v.) route is more effective than the others, especially the intramuscular (i.m.) route, based on the monitoring of venom/antivenom pharmacokinetics in the systemic circulation. Recent evidence suggests that the lymphatic system may be crucial in abolishing venom action. Methods: A preclinical study was performed to determine the optimal administration route with emphasis on venom/antivenom interplay in both the blood and lymph of experimentally envenomed sheep. Timed level measurements were used to compare the antivenom effect on the decrement of venom quantities in both relevant body compartments. Hematological and coagulation parameters, as well as proportions of developed anti-antivenom IgGs, were evaluated. Results: The i.m. antivenom resulted in faster and greater lymphatic absorption and complete neutralization of the venom, whereas the i.v. antivenom only slowed its absorption. The total amount of venom reaching the lymph (AUC0-t) was two times lower after i.m. administration. In the systemic circulation, i.m. antivenom had a lower peak concentration (cmax) and a longer time to reach it (tmax). However, the total venom exposure was three times lower than with i.v. antivenom. Irrespective of the treatment approach, both groups showed improvement in blood disorders with no significant difference in humoral response against equine F(ab’)2 fragments. Conclusions: I.m. administration proved to be a viable option for the snakebite management.
Hubungan Rendahnya Kadar Kalsium Sebagai Prediktor Keparahan Pasien STEMI yang di Rawat di RSUD Bengkalis dan di Hubungkan dengan Skor Killip
Authors: Abdi Taufik , Khairul Deddy 
Published: February 2025

Infark miokard akut dengan elevasi segmen ST (STEMI) merupakan salah satu bentuk sindrom koroner akut yang memiliki tingkat mortalitas dan morbiditas tinggi. Studi ini bertujuan menganalisis hubungan antara rendahnya kadar kalsium sebagai prediktor keparahan pasien STEMI yang dirawat di RSUD Bengkalis Dan Di Hubungkan Dengan Skor KILLIP. Studi ini merupakan penelitian cross-sectional dengan 62 sampel pasien yang didiagnosis STEMI di RSUD Bengkalis antara Juni dan Agustus 2024. Data demografis dan faktor risiko seperti hipertensi, diabetes, hiperkolesterol, riwayat merokok, serta riwayat pengobatan dianalisis menggunakan uji Mann Whitney untuk menilai hubungan dan signifikansi. Kriteria inklusi meliputi pasien dewasa (≥ 18 tahun) dengan diagnosis STEMI terverifikasi berdasarkan klinis, EKG, Hs Troponin I, dan kadar kalsium ion yang diperiksa saat masuk UGD. Kriteria eksklusi mencakup pasien dengan riwayat penyakit ginjal kronis atau penggunaan obat yang mempengaruhi kadar kalsium Pemeriksaan Hs Troponin I menggunakan automatic analyzer DrawayI STAR 500 dengan metode CLIA, dan pemeriksaan kalsium dengan menggunakan automatic biochemistry analyzer DIRUI dengan metode pewarna metalokromik Arsenazo II. Dengan menggunakan uji Mann Whitney menunjukkan bahwa ditemukan hubungan yang signifikan antara Hs Troponin I dengan tingkat keparahan STEMI (p<0,001). Dengan menggunakan uji Mann Whitney menunjukkan bahwa ditemukan hubungan yang signifikan antara kalsium dengan tingkat keparahan STEMI (p<0,001). Hasil penelitian ini mendukung potensi Kalsium sebagai biomarker tambahan dalam penilaian keparahan STEMI. Kalsium ion yang lebih rendah berhubungan dengan keparahan STEMI yang lebih tinggi, dan dapat membantu dalam pengambilan keputusan klinis yang lebih baik.
Hipermobilitas Sendi pada Anak-anak dengan Idiopatik Skoliosis
Authors: Winata Handy 
Published: February 2025

Abstrak Hipermobilitas sendi adalah suatu keadaan dimana gerakan sendi kecil dan sendi besar meningkat, sehubungan dengan gerakan normal serta lebih sering terjadi pada anak-anak, dan lebih banyak pada anak perempuan. Hipermobilitas sendi didiagnosis hampir setengahnya pada anak-anak dengan skoliosis idiopatik, dengan derajat ringan dan sedang, serta biasanya terjadi lebih tinggi pada skoliosis dengan skoliosis lengkung tunggal. Skoliosis idiopatik adalah suatu keadaan skoliosis dimana secara klinis dan radiologis tidak ditemukan adanya penyebab khusus.Kata kunci : hipermobilitas sendi, idiopatik skoliosisÂ Abstract Joint hypermobility is a state where the movement of the small joints and large joints increased with respect to normal movement and is more common in children, and more in girls. Joint hypermobility was diagnosed almost by half in children with idiopathic scoliosis, with mild and moderate, and usually occurs higher in the single-curve scoliosis. Idiopathic scoliosis is a condition in which the scoliosis is clinically and radiologically did not reveal any specific cause. Key words: joint hypermobility, idiopathic scoliosisÂ
Farmakoterapi Mutakhir Keganasan
Authors: Kurnia Yasavati 
Published: February 2025

AbstrakAkhir-akhir ini kasus keganasan meningkat dengan pesat, terutama kanker paru-paru,menjadi penyebab kematian kedua setelah penyakit jantung. UICC (Union for International Cancer Control) telah mendeklarasikan Debunk the Myth of Cancer dalam peringatan Hari Kanker Sedunia2014.Dalam dekade akhir ini, banyak kemajuan dalam mengenali patofisiologi kanker, sehinggaditemukan sediaan-sediaan baru yang dibuat berdasarkan imunologis misalnya sediaan biologis,sediaan antiangiogenesis, sediaan target dan lain-lain. Diharapkan dengan sediaanâ€“sediaan ini yanglebih efektif, pemberiannya dapat per-oral satu kali sehari, sehingga meningkatkan kepatuhanpenderita. Dengan demikian dapat memperpanjang masa survival dari penderita kanker.Masih diperlukan banyak penelitian lain yang akan semakin memberikan kenyamanan bagipenderita kanker yang biasanya sudah ditakuti dengan â€œmomok kemoterapiâ€, sehingga menghindar dari pengobatan rasional dan lari ke pengobatan alternatif.Kata kunci: mitos kanker, patofisiologi kanker, sediaan baru antikankerÂ AbstractsThe incedence of malignancy is increasing fast in recent years, especially lung cancer, whichnow the second cause of mortality after cardiovaskular diseases. UICC (Union for International Cancer Control) declared â€œDebunk the myth of cancerâ€ as the topioc of this year World Cancer day 2014. In recent years there has been marked progress in understanding the pathophysiology of cancer, since then nemerous new anticancer have been developed based on anti-inflamation, imunologies pro- perties and angiogenesis process. Most of this new anticancer can be deliveredoral, given once a day and can make patientâ€™s compliance better. With this new development in anticancer therapy, we hope the survival rate will prolonged and Cancer patients will not take â€œalternative therapyâ€ because their are afraid of Chemotherapy.Key Words: Cancer Myth, Pathophysiology of canc
Gejala, Diagnosis, dan Tata Laksana pada Pasien Peminum Kafein yang Mengalami Adiksi
Authors: Winata Susanty Dewi 
Published: February 2025

Â AbstrakKafein merupakan zat psikoaktif yang paling sering dikonsumsi oleh masyarakat. Kafein digunakan sebagai stimulan sistem saraf pusat dan mempercepat metabolisme.Â Konsumsi kafein berguna untuk meningkatkan kewaspadaan, menghilangkan kantuk, dan menaikkan mood. Penggunaan kafein juga dapat menyebabkan gangguan ansietas dan gangguan tidur yang terinduksi kafein Kondisi intoksikasi kafein dapat memberikan gejala antara lain gelisah, gugup, insomnia, emosional, urinasi berlebihan, gangguan pencernaan, otot berkedut, denyut jantung yang cepat dan tidak teratur. Adiksi kafein dapat menyebabkan intoksikasi, keadaan putus kafein, dan kafein dependen. Konsumsi kafein yang bekelanjutan dapat mempengaruhi beberapa faktor seperti efek farmakologi kafein, predisposisi genetik, gejala putus kafein, usia, dan norma sosial. Semakin bertambahnya coffee shop di Indonesia, menyebabkan semakin banyaknya masyarakat yang berpeluang menjadi adiksi kafein, sebaiknya diberikan sosialisasi mengenai pencegahan ketergantungan kafein, tatalaksana sesuai gejala simptomatik dan dapat diberikan psikoterapi.Â Kata kunci: kafein, adiksi kafein, intoksikasi kafeinÂ AbstractCaffeine is a psychoactive agent and the most consumed substance in the society. Caffeine is commonly used to stimulate central nervous system and accelerate metabolism. Consuming caffeine can increase alertness, mood, and get rid of drowsiness. Excess in caffeine can cause both sleep and anxiety disorders. Caffeine intoxication can cause symptoms such as anxiety, nervous disorder, insomnia, excessive emotion, excessive diuresis, gastrointestinal disorders, wrinkled muscle, tachycardia and arrhythmia. Caffeine addiction can cause caffeine intoxication. Continuous consumption of caffeine affects many factors such as caffeine pharmacology effects, genetic predisposition, caffeine-withdrawal symptoms, age, and social norms. The increasing the number of coffee shops in Indonesia increase the chance of people to be caffeine addict. Hence,Â socialization on preventing caffeine addiction, management of caffeine addiction, and psychotherapy should be given.Â Key words: caffeine, caffeine addiction, caffeine intoxicationÂ