bluuebunny/crossref_metadata_2025_split 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.
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.
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.
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.