bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Efficacy of Traditional Chinese Herbal Medicine Across Multiple Cardiovascular Diseases: An Umbrella Review of Systematic Reviews of Randomized Controlled Trials
Authors: Li Xi , Yu Tao , Jiang Qin , Tan Jin , Liu Ke 
Published: January 2024

Abstract:
Traditional Chinese herbal medicine (CHM) has been extensively used in cardiovascular disease (CVD) in modern clinical practice, alone or in combination with conventional treatment. However, its efficacy has not been assessed extensively. From inception until August 2023, we systematically searched 5 public literature databases to conduct the umbrella review. The inclusion criterion is systematic reviews of randomized controlled trials investigating the effect of CHM in the contemporary management of CVDs. The quality of the included systematic reviews, the certainty of the evidence, and the potential risk of bias were assessed. Five hundred and thirty-nine systematic reviews, including 346 studies in Chinese and 193 in English, were selected before the quantitative synthesis. The methodological quality was generally moderate, with a median value of 11. The favorable efficacy of CHM was primarily presented on 5 main conditions: coronary artery disease, hypertension, heart failure, restenosis, and angina pectoris. CHM, with or without conventional treatment, showed a consistent beneficial effect in various CVDs. Nevertheless, the magnitude of the effect requires further investigation as the lack of relevant research and the complexity of the clinical practice of CHM.
Determining Plasma Tacrolimus Concentrations Using High-Performance LC-MS/MS in Renal Transplant Recipients
Authors: Alonge Mirabel , Coller Janet K. , Reuter Stephanie E. , Jesudason Shilpanjali , Sallustio Benedetta C. 
Published: January 2024

Background:
Whole-blood therapeutic drug monitoring of tacrolimus is conducted to maintain tacrolimus concentrations within a safe and effective range. Changes in hematocrit cause variability in blood concentrations of tacrolimus because it is highly bound to erythrocytes. Measuring plasma concentrations may eliminate this variability; however, current methods have limitations owing to the use of cross-reactive immunoassays, plasma separation at nonbiological temperatures, and lack of clinical validation. This study aimed to develop and validate a clinically applicable method to measure plasma tacrolimus concentrations in renal transplant recipients and to examine the concentration differences between genotypic CYP3A5 expressors and nonexpressors.

Methods:
Plasma tacrolimus concentrations were measured in 9 stable renal transplant recipients who were genotypic CYP3A5 expressors or nonexpressors. Tacrolimus was extracted from plasma using solid-phase extraction, and liquid chromatography-tandem mass spectrometry was used for detection and quantitation.

Results:
This assay was sensitive, selective, and linear between 100 and 5000 ng/L, with intraassay and interassay imprecision and inaccuracy <10% and <5% respectively. The extraction recovery of tacrolimus and ascomycin was 74%. Matrix ion suppression effects were 31.5% and 35% with overall recovery of 50.6% and 48.3% for tacrolimus and ascomycin, respectively. Whole-blood concentrations accounted for approximately 46% of the variation in plasma concentrations in CYP3A5 expressors and nonexpressors. No difference in dose-adjusted whole-blood and plasma concentrations was observed between CYP3A5 expressors and nonexpressors.

Conclusions:
This assay is clinically applicable with excellent performance and demonstrated that tacrolimus plasma concentrations highly correlated with whole-blood concentrations.
The efficacy of purified pollen extract for reducing vasomotor symptoms in women: a systematic review and meta-analysis
Authors: Acquarulo Erica L. , Hernandez Emily C. , Kodzodziku Fatbardha , Nemec Eric C. 
Published: January 2024

Abstract

Importance
Menopause impacts the quality of life for women, with symptoms varying from hot flashes to night disturbances. When menopausal hormonal therapy is contraindicated or women refuse menopausal hormonal therapy, many consider alternatives such as pollen extract for treating vasomotor symptoms.

Objective
This meta-analysis focuses on the impact of using purified pollen extract as a treatment option to reduce vasomotor symptoms in women, specifically focusing on symptoms such as hot flashes, night disturbances, myalgias, and depression.

Evidence Review
A comprehensive literature search was conducted using the following Boolean search string “women OR females” AND “purified pollen OR pollen extract OR cytoplasmic pollen OR Bonafide OR Femal OR Estroven OR Serelys” AND “menopausal symptoms OR vasomotor symptoms OR hot flashes OR night sweats OR sleep disturbance.” Publications in English from 2003 to the present were included. To assess the risk of bias, authors used the Cochrane Risk-of-Bias 2 for a randomized controlled trial and Risk-of-Bias in Non-Randomized Studies of Interventions (ROBINS-I) for observational studies. Using ReviewManager, a Der Simonian–Laird random-effects model meta-analysis was conducted to determine the standardized mean differences (SMDs) in the outcomes for each study.

Findings
Five articles were retained: one randomized controlled trial and four observational studies (N = 420). An overall decrease in scores from the baseline of studies compared with a 3-month follow-up after purified cytoplasm of pollen (PCP) treatment was recognized when compiling the data. Overall, there was significant improvement across all outcomes at 3 months: hot flashes demonstrated an overall improvement in SMD of −1.66 (P < 0.00001), night disturbance scores were improved with an SMD of −1.10 (P < 0.0001), depression scores were improved with an SMD of −1.31 (P < 0.0001), and myalgia had an improvement in SMD of −0.40 (P < 0.00001). When controlled studies were pooled for meta-analysis, outcomes, however, were no longer statistically significant.

Conclusions and Relevance
Evaluating the risk-to-benefit ratio of alternative therapies, such as PCP extract, is important to care for women who cannot take traditional vasomotor symptom therapies. Pooled data from controlled studies evaluating PCP extract suggest that vasomotor symptom improvements seen in noncontrolled studies may have been due to the placebo effect; however, its use was not associated with significant adverse effects.
Prolactinoma in postmenopausal women: a systematic review
Authors: Carneiro Marcela Souza , de Mira Ticiana Aparecida Alves , Yela Daniela Angerame , Benetti-Pinto Cristina Laguna 
Published: January 2024

Abstract

Importance
Prolactinomas occurring during the reproductive period exhibit a characteristic behavior. There are, however, gaps in the literature regarding the behavior of these tumors after menopause.

Objective
This study aimed to review and characterize the influence of menopause on prolactinoma behavior.

Evidence review
A systematic review of observational prospective or retrospective studies and clinical trials on prolactinomas was conducted in two situations: tumors diagnosed in the reproductive period (before menopause), with follow-up in the postmenopausal period, or prolactinomas diagnosed in the postmenopausal period, without language or date restrictions. Data extracted from the articles included patient and tumor characteristics (prolactinoma type, previous treatment, symptoms, and serum prolactin [PRL] levels).

Findings
This study included five studies comprising 180 participants. Prolactinomas diagnosed in women of reproductive age are treated with dopaminergic agonists (DAs), with indications of treatment withdrawal after menopause, exhibited stable tumor behavior and PRL levels. Considering the diagnosis during the postmenopausal period, macroprolactinomas were more prevalent and showed tumor shrinkage when DAs were used. Cabergoline, the most commonly used drug, lowers PRL levels and reduces symptoms associated with adenoma.

Conclusions and Relevance
Microadenomas diagnosed before menopause can be followed up without treatment. Prolactinomas diagnosed after menopause are typically macroadenomas. Cabergoline remains the treatment of choice in the presence of clinical or compressive symptoms. We recommend at least one annual follow-up for such patients.
Combined application of B-scan ultrasonography and eye-steering ultrawide field imaging to improve the detection of retinal tears before cataract surgery
Authors: Meng Jiaqi , Cheng Kaiwen , Huang Zhiqian , He Wenwen , Zhang Keke , Lu Yi , Zhu Xiangjia 
Published: January 2024

Purpose:
To investigate the efficacy of combined application of B-scan ultrasonography (US) and ultrawide field imaging (UWFI) in detecting retinal tears before cataract surgery.

Methods:
2552 eyes of 1277 cataract patients were enrolled and received both B-scan US and UWFI examinations preoperatively. Three types of combination were applied: type 1 (union, B-scan US or centered UWFI), type 2 (intersection, B-scan US and centered UWFI), and type 3 (B-scan US and eye-steering UWFI). Sensitivity and specificity of detecting retinal tears by different methods were assessed.

Results:
Totally 4.55% (116/2552) of eyes were presented with retinal tears. The sensitivity of B-scan US and UWFI was 87.93% and 84.48%, and specificity was 95.16% and 99.79%, respectively. By applying type 1 and 2 combination, the sensitivity was 98.28% and 74.14%, and specificity was 95.03% and 99.92%, respectively. By type 3 combination, the sensitivity increased to 95.69% and specificity to 99.88%, both of which were comparable to indirect ophthalmoscopy regardless of the number, type and location of tears (P>0.05). In eyes with any cataract type or axial length, type 3 combination also gained comparable performance to indirect ophthalmoscopy.

Conclusion:
Combined application of B-scan US and eye-steering UWFI presented satisfactory performance in detecting retinal tears before cataract surgery.
Ab Interno Ahmed Glaucoma Valve Plugs In An Eye With Persistent Hypotony
Authors: Me Rao , LeRose Jennifer , Alfaro Cesar , Lee Patrick S.Y. , Lin Xihui 
Published: January 2024

Purpose:
This case report aims to describe a new method for increasing intraocular pressure (IOP) in patients with acute hypotony resulting from uveitis flare-ups and preexisting glaucoma drainage devices. The temporary glaucoma tube plug method described is effective and safe.

Methods:
This case report presents a 47-year-old female patient with a history of chronic panuveitis and secondary glaucoma, who had 2 previously implanted Ahmed glaucoma valves. The patient developed panuveitis flare-up and persistent hypotony. A novel method of ab interno plugging of the glaucoma tubes using 2-0 prolene suture plugs was performed. Following treatment, the IOP increased successfully and remained within the normal range.

Conclusion:
The temporary ab interno glaucoma tube plug method effectively increased IOP in a patient with 2 preimplanted Ahmed glaucoma valves with persistent low IOP due to uveitis.
Effect of “365 Breathing Technique” on Intraocular Pressure and Autonomic Functions in Patients With Glaucoma: A Randomized Controlled Trial
Authors: Dada Tanuj , Gwal Rajat S. , Mahalingam Karthikeyan , Chandran Dinu Santha , Angmo Dewang , Gupta Shikha , Velpandian Thirumurthy , Deepak Kishore K. 
Published: January 2024

Précis:
Patients with primary open angle glaucoma were advised to follow the “365 breathing technique” for 6 weeks in addition to their pharmacological glaucoma treatment. It helped to reduce intraocular pressure (IOP), stress biomarker—cortisol, and improve autonomic dysfunction.

Objective:
To study the effect of the “365 breathing technique” on IOP, autonomic functions, and stress biomarkers in patients with primary open angle glaucoma.

Methods:
In this randomized, controlled, interventional trial, after randomization, 40 patients in the intervention group followed “365 breathing” (three times a day, breathing rate: 6 cycles/min for 5 min) in addition to their pharmacological glaucoma treatment and 40 patients in the control group continued only with their pharmacological glaucoma treatment. IOP, serum cortisol, heart rate variability (HRV), and heart rate response to deep breathing test (DBT) were recorded at preintervention and 6 weeks postintervention.

Results:
The mean IOP, serum cortisol, parameters of the HRV test, and DBT were comparable between the two groups at baseline. At the 6-week follow-up, in the intervention group, mean IOP was significantly lower (16.09 ± 2.24 vs 18.38 ± 1.58 mm Hg, P = 0.03) and serum cortisol were significantly lower (13.20 ± 3.11 vs 14.95 ± 2.60 mcg/dL, P = 0.038) compared with the control group. In the HRV test, time domain analysis showed a significant difference in the root mean square of the successive difference between RR interval values between both groups at 6 weeks (P = 0.015) pointing towards higher postintervention parasympathetic activation in the intervention group. In frequency domain analysis (HRV test), the ratio of the low-frequency component to the high-frequency component was significantly lower in the intervention group at 6 weeks (1.65 vs 1.79, P = 0.019) indicating a shift in sympathovagal balance towards greater vagal modulation.
There was a significant increase in delta heart rate (P = 0.019) and expiratory:inspiratory ratio (P = 0.011) in the intervention group at 6 weeks when compared with baseline values, indicating improved parasympathetic reactivity to DBT.

Conclusion:
“365 breathing” technique can reduce IOP and serum cortisol, and improve autonomic dysfunction in patients with glaucoma.
One-Year Outcomes of the PAUL Glaucoma Implant Compared With the Ahmed Glaucoma Valve for the Treatment of Silicone Oil Glaucoma
Authors: Karapapak Murat , Olgun Ali 
Published: January 2024

Précis:
Longer-term studies with a larger sample size are needed to demonstrate the superiority or equivalence of these procedures.

Objective:
To evaluate the outcomes of the PAUL glaucoma implant (PGI) and Ahmed glaucoma valve (AGV) in patients with secondary glaucoma caused due to silicone oil emulsification.

Patients and Methods:
A retrospective examination was conducted using the medical records of 36 patients who developed secondary glaucoma due to silicone oil emulsification after vitreoretinal surgery and then underwent PGI and AGV implantation surgery. The main outcome measures in the PGI and AGV groups were intraocular pressure (IOP) and its change, the number of antiglaucoma medications, and postoperative complications during the 12-month follow-up period. IOP of <6 mm Hg is used to define hypotonia.

Results:
There was no statistically significant difference among the patients who underwent PGI and AGV surgeries in terms of IOP averages, both preoperatively and postoperatively on day 1, week 1, month 1, month 3, month 6, and month 12 (P > 0.05). Before PGI and AGV implantation, the mean IOP was 40 ± 13 mm Hg and 39.3 ± 10 mm Hg, and the mean number of medications was 3.8 ± 0.4 and 4 ± 0, respectively. At the end of the 12-month follow-up period, the mean IOP was 13.5 ± 2.2 (P < 0.001) mm Hg and 14.9 ± 4.2 (P < 0.001) mm Hg, whereas the mean number of glaucoma medications decreased to 1.7 ± 1.3 (P < 0.001) and 1.9 ± 1.8 (P < 0.001) in the PGI and AGV groups, respectively. Surgical success was achieved in 17 of 18 eyes (94%) in the PGI group and 16 of 18 eyes (89%) in the AGV group.

Conclusions:
Although the outcomes were similar in both the PGI and AGV groups, complications requiring medical and surgical intervention were less common in the PGI group. Longer-term studies with a larger sample size are needed to demonstrate the superiority or equivalence of these procedures.
Biomechanical and Vascular Metrics Between Eyes of Patients With Asymmetric Glaucoma and Symmetric Glaucoma
Authors: Harvey Devon H. , Roberts Cynthia J. , Mahmoud Ashraf M. , Nuñez Fernando M. , Ma Yanhui , Fleming Gloria P. 
Published: January 2024

Précis:
Corneal hysteresis (CH) and pulsatile ocular blood volume (POBV) were significantly lower in the eye with greater damage in asymmetric glaucoma, without a difference in intraocular pressure (IOP) or central corneal thickness (CCT), and no difference in elastic parameters.

Objective:
To compare biomechanical and vascular metrics between the eyes of patients with asymmetric glaucoma (ASYMM) and those with symmetric glaucoma (SYMM).

Patients and Methods:
Forty-five patients were prospectively recruited and divided into ASYMM, defined as cup-to-disc (C/D) ratio difference >0.1 between eyes and SYMM, with C/D difference ≤0.1. For ASYMM, the smaller C/D was defined as the best eye (“best”) and the fellow eye was defined as the worst eye (“worse”). All metrics were subtracted as “worse” minus “best,” including the viscoelastic parameter CH, and elastic parameters from the Corvis ST, including stiffness parameter at first applanation, stiffness parameter at highest concavity, integrated inverse radius, deformation amplitude ratio, IOP, CCT, mean deviation (MD), ganglion cell complex (GCC), and POBV were included. Paired t tests were performed between eyes in both groups. Statistical analyses were performed with SAS using a significance threshold of P <0.05.

Results:
For ASYMM (16 patients), “worse” showed significantly lower CH (−0.76 ± 1.22), POBV (−0.38 ± 0.305), MD (−3.66 ± 6.55), and GCC (−7.9 ± 12.2) compared with “best.” No other parameters were significantly different. For SYMM (29 patients), there were no significantly different metrics between eyes.

Conclusions:
Lower CH, POBV, GCC, and worse MD were associated with greater glaucomatous damage in asymmetric glaucoma without a difference in IOP or CCT. Lower CH and GCC are consistent with previous studies. POBV, a new clinical parameter that may indicate reduced blood flow, is also associated with greater damage.
Surgical approach to and morphology of visually significant persistent pupillary membranes
Authors: Chen Wan , Chen Kexin , Chen Hui , Wang Qiwei , Lin Duoru , Qin Tingfeng , Bai Bingyu , Lin Zhuoling , Li Jing , Li Xiaoyan , Lin Xiaoshan , Zhong Qiuping , Chen Weirong 
Published: January 2024

Purpose:
To characterize the morphology of persistent pupillary membranes (PPMs) in pediatric patients and explore the corresponding surgical approaches.

Setting:
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

Design:
Prospective observational study.

Methods:
Consecutive pediatric patients with PPMs who underwent surgery from April 2020 to July 2022 were included. PPM morphology was assessed and categorized according to its anatomic relationship with crystalline lens and distribution of iris strands. The surgical approaches for different morphologies of PPMs were described in detail. The visual outcome and operation-related complications were recorded.

Results:
31 eyes from 19 patients were included with the mean age of 7.2 years. 3 morphological variants of PPMs were observed: type I (51.6%, 16/31), a spider-like appearance and no adhesion to the anterior lens capsule (ALC); type II (38.7%, 12/31), a loose central adherence to the ALC and partially thick iris strands attached to the iris collarette; type III (9.7%, 3/31), a tight central adherence to the ALC and only silk-like iris strands. Surgeries were performed with a natural pupil size in type I, while dilated pupil in the other types. The adhesions between PPM and the ALC were separated by viscoelastic injection in type II and by discission needles in type III. The corrected distance visual acuity was significantly improved from 0.34 ± 0.18 logMAR preoperatively to 0.17 ± 0.09 logMAR postoperatively (P < .001). No operation-related complications were observed during 9.5-month follow-up.

Conclusions:
PPMs were categorized into 3 types according to their different morphologies, which helped to determine the best surgical strategy.
Time-varying phase synchronization of resting-state functional magnetic resonance imaging reveals a shift toward self-referential processes during sustained pain
Authors: Lou Wutao , Li Xiaoyun , Jin Richu , Peng Weiwei 
Published: January 2024

Abstract
Growing evidence has suggested that time-varying functional connectivity between different brain regions might underlie the dynamic experience of pain. This study used a novel, data-driven framework to characterize the dynamic interactions of large-scale brain networks during sustained pain by estimating recurrent patterns of phase-synchronization. Resting-state functional magnetic resonance imaging signals were collected from 50 healthy participants before (once) and after (twice) the onset of sustained pain that was induced by topical application of capsaicin cream. We first decoded the instantaneous phase of neural activity and then applied leading eigenvector dynamic analysis on the time-varying phase-synchronization. We identified 3 recurrent brain states that show distinctive phase-synchronization. The presence of state 1, characterized by phase-synchronization between the default mode network and auditory, visual, and sensorimotor networks, together with transitions towards this brain state, increased during sustained pain. These changes can account for the perceived pain intensity and reported unpleasantness induced by capsaicin application. In contrast, state 3, characterized by phase-synchronization between the cognitive control network and sensory networks, decreased after the onset of sustained pain. These results are indicative of a shift toward internally directed self-referential processes (state 1) and away from externally directed cognitive control processes (state 3) during sustained pain.
Validation of the ANDON KD-595 automated upper-arm blood pressure monitor according to the universal standard
Authors: Liu Kui , Wu Dan , Bing Sen , Li Lin-Yi 
Published: January 2024

Objective
To validate the ANDON KD-595 automated upper-arm blood pressure monitor for clinical use and self-measurement blood pressure measurement according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard.

Methods
Same left-arm blood pressure was sequentially measured in 90 qualified adult participants and compared with a standard mercury sphygmomanometer. A total of 270 comparison pairs were obtained and analyzed according to the universal standard.

Results
For the validation Criterion 1 of the universal standard, the mean ± SD of the differences between the test device and reference blood pressure readings was 0.96 ± 5.35 and 0.82 ± 5.08 mmHg for SBP and DBP, respectively. For Criterion 2, the SDs of the averaged blood pressure differences between the test device and reference blood pressure per subject were 4.84 and 4.64 mmHg (with maximum allowed SDs of 6.87 and 6.89 mmHg) for SBP and DBP, respectively.

Conclusion
The ANDON KD-595 automated upper-arm blood pressure monitor passed all the validation requirements according to the AAMI/ESH/ISO Universal Standard and can be recommended for clinical use and self-measurement blood pressure measurement in the general population.