bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of traditional Chinese exercises on cardiac rehabilitation in patients with myocardial infarction: a meta-analysis of randomized controlled trials
Authors: Zhang Jingfang , Weng Jieqiong , Yuan Mengfei , Shen Xingchen , Weng Yayi , Shen Xiaoxu 
Published: October 2023

ObjectiveTraditional Chinese exercises (TCE) are excellent cardiac rehabilitation (CR) training that can effectively improve cardiorespiratory fitness. However, there is no published meta-analysis of TCE on CR in patients with myocardial infarction (MI). Therefore, this study aimed to provide a comprehensive evaluation from multiple perspectives.MethodsThis meta-analysis is based on the Cochrane Handbook of Systematic Reviews. Eight databases were searched from the date of database construction to March 15, 2023. Two investigators independently screened the literature and assessed their quality. The meta-analysis was performed with RevMan5.4 software.ResultsA total of 21 articles involving 1,890 patients were included. N-terminal pro-brain natriuretic peptide (NT-proBNP) in the TCE group were lower than the control group (MD = −96.34, 95%CI: −140.69 ∼−51.98, P &lt; 0.00001, I2 = 96%), the left ventricular ejection fraction (LVEF) in the TCE group was higher than the control group (MD = 4.58, 95%CI: 3.28–5.88, P &lt; 0.00001, I2 = 79%), the left ventricular end diastolic dimension (LVDD) in TCE group was lower than the control group (MD = −3.83, 95%CI: −5.27 ∼−2.38, P &lt; 0.00001, I2 = 94%), the left ventricular end systolic diameter (LVESD) in TCE group was lower than the control group (MD = −2.17, 95%CI: −4.10 ∼−0.24, P &lt; 0.00001, I2 = 96%), The 6-minute walk test (6MWT) in the TCE group was higher than the control group (MD = 69.60, 95%CI: 34.59–104.60, P &lt; 0.00001, I2 = 99%), the oxygen uptake (VO2) in the TCE group was higher than the control group (MD = 4.38, 95%CI: 2.25–6.51, P &lt; 0.00001, I2 = 94%), the 36-item short form survey (SF-36) in the TCE group was higher than the control group (MD = 13.34, 95%CI: 9.25–17.42, P = 0.008, I2 = 75%), the Hamilton Anxiety Scale (HAMA) in the TCE group was lower than the control group (MD = −4.34, 95%CI: −5.18 ∼−3.50, P = 1.00, I2 = 0%), the Hamilton Depression Scale (HAMD) in the TCE group was lower than the control group (MD = −3.48, 95%CI: −5.35 ∼−1.61, P = 0.0002, I2 = 88%), the incidence of major adverse cardiac events (MACEs) in the TCE group was lower than the control group (RR = 0.31, 95%CI: 0.20–0.47, P = 0.52, I2 = 0%). Subgroup analysis revealed differences in TCE types could be a potential source of heterogeneity.ConclusionMI patients who used TCE have not only notable improvements in cardiopulmonary function, physical function, quality of life, and emotions but also reduced the incidence of MACEs. Tai Chi might be more efficient than Ba Duan Jin.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023408675.
Risk factors for major adverse cardiovascular events after coronary artery bypass grafting using radial artery grafts
Authors: Xia Tianyu , Li Bo , Zhang Wei , Wang Zhe , Ye Xiaofeng , Zhou Mi , Li Haiqing , Qiu Jiapei , Zhu Yunpeng , Zhao Qiang 
Published: September 2023

BackgroundCoronary artery bypass grafting using radial artery grafts (RA-CABG) has improved long-term outcomes. However, major adverse cardiovascular events (MACE-4, including all-cause death, myocardial infarction, stroke, and repeat revascularization) after RA-CABG still occur and the predictors remain uncertain. This study aimed to detect independent risk factors of MACE-4 after RA-CABG.MethodsThis is a retrospective case-control study (NCT04935086) conducted among patients who underwent primary isolated RA-CABG between 2009 and 2019 in our center. Baseline characteristics, procedure characteristics, and medication use were compared to identify the independent predictors of MACE-4, all-cause death, and myocardial infarction (MI) with univariate and then multivariate logistic regression.ResultsA total of 370 patients were analyzed using a mean follow-up duration of 48.8 ± 41.0 months. MACE-4, all-cause death, and MI occurred in 102 (27.6%), 27 (7.3%), and 66 patients (17.8%), respectively. Multivariate analysis revealed prior MI (OR = 2.12, 95%CI 1.05–4.25, P = 0.04) and RA to the left anterior descending artery (LAD) (non-left internal mammary artery to LAD) (OR = 4.87, 95%CI 1.41–16.82, P = 0.01) as independent predictors of MACE-4 after surgery. Female (OR = 4.53, 95%CI 1.06–19.41, P = 0.04), left ventricular ejection fraction (LVEF) &lt;40% (OR = 21.00, 95%CI 1.20–368.35, P = 0.04), and RA to LAD (OR = 8.55, 95%CI 1.35–54.10, P = 0.02) were independent predictors of all-cause death. Prior MI (OR = 3.11, 95%CI 1.40–6.94, P = 0.006) emerged as an independent predictor of MI.ConclusionOur data suggested that prior MI and RA to LAD were independent predictors of MACE-4 after RA-CABG. Being female, having an LVEF &lt; 40% and RA to LAD indicated death. Prior MI indicated new MI.
Correlation between the rate of morphological changes and rupture of intracranial aneurysms during one cardiac cycle analyzed by 4D-CTA
Authors: Wang Binghao , Shen Chengen , Su Zhongzhou , Nie Xiaohu , Zhao Jingjing , Qiu Sheng , Li Yuntao 
Published: October 2023

ObjectiveThis study aimed to analyze the relationship between the rate of morphological changes and intracranial aneurysm rupture during the cardiac cycle.MethodsEighty-four patients with intracranial aneurysms were retrospectively analyzed and divided into the rupture (42 cases) and unruptured (42 cases) groups. Four-dimensional computed tomography angiography (4D-CTA) was performed to collect quantitative parameters of aneurysm morphology and calculate the morphological change rate. The potential factors associated with aneurysm rupture were determined by comparing the general clinical data and rate of change in the location and morphology of the aneurysm between the two groups.ResultsEach morphological change rate in the rupture group was generally higher than that of the unruptured group. The rate of dome height change and aneurysm volume change were independent factors associated with aneurysm rupture. ROC curve analysis revealed that the diagnostic accuracy of the aneurysm volume change rate was higher. When the volume change rate was 12.33%, the sensitivity and specificity of rupture were 90.5 and 55.8%, respectively.ConclusionThe rate of change in dome height and volume of intracranial aneurysms during one cardiac cycle were independent factors associated with aneurysm rupture.
Gad1 knock-out rats exhibit abundant spike-wave discharges in EEG, exacerbated with valproate treatment
Authors: Liu Dongyu , Fujihara Kazuyuki , Yanagawa Yuchio , Mushiake Hajime , Ohshiro Tomokazu 
Published: September 2023

ObjectiveTo elucidate the functional role of gamma-aminobutyric acid (GABA)-ergic inhibition in suppressing epileptic brain activities such as spike-wave discharge (SWD), we recorded electroencephalogram (EEG) in knockout rats for Glutamate decarboxylase 1 (Gad1), which encodes one of the two GABA-synthesizing enzymes in mammals. We also examined how anti-epileptic drug valproate (VPA) acts on the SWDs present in Gad1 rats and affects GABA synthesis in the reticular thalamic nucleus (RTN), which is known to play an essential role in suppressing SWD.MethodsChronic EEG recordings were performed in freely moving control rats and homozygous knockout Gad1 (–/–) rats. Buzzer tones (82 dB) were delivered to the rats during EEG monitoring to test whether acoustic stimulation could interrupt ongoing SWDs. VPA was administered orally to the rats, and the change in the number of SWDs was examined. The distribution of GABA in the RTN was examined immunohistochemically.ResultsSWDs were abundant in EEG from Gad1 (–/–) rats as young as 2 months old. Although SWDs were universally detected in older rats irrespective of their Gad1 genotype, SWD symptom was most severe in Gad1 (–/–) rats. Acoustic stimulation readily interrupted ongoing SWDs irrespective of the Gad1 genotype, whereas SWDs were more resistant to interruption in Gad1 (–/–) rats. VPA treatment alleviated SWD symptoms in control rats, however, counterintuitively exacerbated the symptoms in Gad1 (–/–) rats. The immunohistochemistry results indicated that GABA immunoreactivity was significantly reduced in the somata of RTN neurons in Gad1 (–/–) rats but not in their axons targeting the thalamus. VPA treatment greatly increased GABA immunoreactivity in the RTN neurons of Gad1 (–/–) rats, which is likely due to the intact GAD2, another GAD isozyme, in these neurons.DiscussionOur results revealed two opposing roles of GABA in SWD generation: suppression and enhancement of SWD. To account for these contradictory roles, we propose a model in which GABA produced by GAD1 in the RTN neuronal somata is released extrasynaptically and mediates intra-RTN inhibition.
Altered neural processes underlying executive function in occupational burnout—Basis for a novel EEG biomarker
Authors: Pihlaja Mia , Peräkylä Jari , Erkkilä Emma-Helka , Tapio Emilia , Vertanen Maiju , Hartikainen Kaisa M. 
Published: October 2023

IntroductionAs burnout has become a global pandemic, there is a call for improved understanding and detection of alterations in brain functions related to it. We have previously reported challenges in executive functions (EFs) in daily life, especially in metacognition, in subjects with occupational burnout, along with alterations in cardiac physiology. In the current study, we focused on the impact of burnout on brain physiology during a task requiring EF.MethodsFifty-four volunteers filled in inventories of burnout, depression, and EF in daily life (BBI-15, BDI, and BRIEF-A). Based on the BBI-15 score, subjects were divided into burnout and non-burnout groups. Subjects performed a Go/NoGo test (Executive RT test) engaging several EFs, while their EEG was recorded. The inventory scores, cognitive performance scores, and event-related potential (N2, P3) amplitudes, latencies, and interpeak latencies (IPLs) were compared between the groups.ResultsThere were significant differences in the BDI and BRIEF-A scores between the groups, with more symptoms of depression and challenges in daily life in the burnout group. There were no differences in objective performance measures in the EF task between the groups. However, centroparietal P3 amplitude was larger, and while there were no differences in N2 or P3 latencies, N2-P3 IPL was longer in the Go condition in the burnout than in non-burnout group. Both ERP measures correlated significantly with burnout symptoms. A regression model from centroparietal P3 amplitude and N2-P3 IPL predicted significantly both the BBI-15 score and the BRIEF-A metacognition index.DiscussionWe conclude that burnout is linked with challenges in EF in daily life and alterations in the underlying neural processes. While cognitive performance in the task was equal, electrophysiological measures differed between the groups. Prolonged N2-P3 IPL points toward slowed transition from one cognitive process to another. Increased P3 amplitude, on the other hand, reflects increased allocation of neural processing resources. This may be a compensatory mechanism, allowing for equal performance with controls. These electrophysiological measures, obtained during the EF task, show promise as brain physiology-based biomarkers of burnout, contributing to its improved and objective detection. In addition, these results indicate occupational burnout is linked with objective alterations in brain physiology.
White matter microstructure and connectivity changes after surgery in male adults with obstructive sleep apnea: recovery or reorganization?
Authors: Chai Yaqiong , Park Hea Ree , Jo Hyunjin , Seo Min Young , Kim Hyo Yeol , Joo Eun Yeon , Kim Hosung 
Published: September 2023

Study objectivesObstructive sleep apnea (OSA) is a prevalent clinical problem significantly affecting cognitive functions. Surgical treatment is recommended for those unable to use continuous positive airway pressure. We aimed to investigate the therapeutic effect of upper airway surgery on the white matter (WM) microstructure and brain connectivity in patients with OSA.MethodsTwenty-one male patients with moderate-to-severe OSA were recruited for multi-level upper airway surgery. Overnight polysomnography (PSG), neuropsychiatric tests, and brain MRI scans were acquired before and 6.1 ± 0.8 months after surgery. Nineteen male patients with untreated OSA were also included as a reference group. We calculated the longitudinal changes of diffusion tensor imaging (DTI) parameters, including fractional anisotropy (ΔFA) and mean/axial/radial diffusivity (ΔMD/AD/RD). We also assessed changes in network properties based on graph theory.ResultsSurgically treated patients showed improvement in PSG parameters and verbal memory after surgery. Globally, ΔFA was significantly higher and ΔRD was lower in the surgery group than in the untreated group. Especially ΔFA of the tracts involved in the limbic system was higher after surgery. In network analysis, higher Δbetweenness and lower Δclustering coefficients were observed in the surgical group than in the untreated group. Finally, the improvement of verbal memory after surgery positively correlated with ΔFA in superior thalamic radiation (p = 0.021), fronto aslant tracts (p = 0.027), and forceps minor tracts (p = 0.032).ConclusionSurgical treatment of OSA can alleviate alterations in WM integrity and disruptions in local networks, particularly for the tracts involved in the limbic system. These findings may further explain the cognitive improvement observed after the treatment of OSA.
Relationship between serum 25-hydroxyvitamin D concentrations and blood pressure among US adults without a previous diagnosis of hypertension: evidence from NHANES 2005–2018
Authors: Che Jinhang , Tong Jin , Kuang Xue , Zheng Caiyin , Zhou Ruoyu , Song Jiaqi , Zhan Xiaodan , Liu Zengzhang 
Published: September 2023

BackgroundThere are various cross-sectional studies that concluded that vitamin D is associated with blood pressure, but randomized controlled studies have not yielded consistent conclusions. Considering many limitations indeed, our study aimed to examine whether concentrations of 25(OH)D are inversely associated with blood pressure in people without a previous diagnosis of hypertension.MethodWe analyzed data from the 2005–2018 National Health and Nutrition Examination Survey. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by applying multivariable logistic regression models. The dose–response relationship was assessed by means of restricted cubic spline regression, and stratification analyses were employed to test the consistency between the subgroups.ResultsOf 17,467 participants aged ≥ 20 years without a previous diagnosis of hypertension, 4,769 had higher blood pressure. Compared with individuals whose 25(OH)D levels were in the bottom quartile (&lt;44.3 nnol/L), adjusting for multiple confounders, the ORs for higher blood pressure were 0.90(95%CI 0.78, 1.05), 0.85(95%CI 0.72, 0.99), and 0.86(95%CI 0.72, 1.02), respectively (P for trend = 0.096). Furthermore, as a continuous variable, 25(OH)D concentrations were non-linearly associated with an increased risk of hypertension (P &lt; 0.001). The interaction between the sleeplessness subgroup and higher blood pressure was significant (P = 0.042).ConclusionIn adults without a previous diagnosis of hypertension in the United States, concentrations of 25(OH)D were inversely associated with higher blood pressure when it was &lt;84 nmol/L.
Case Report: Gonio-endoscopy: a novel approach to minimally invasive glaucoma surgery in a glaucomatous eye
Authors: Matsushita Kenji , Kawashima Rumi , Kanazawa Noriaki , Usui Shinichi , Nishida Kohji 
Published: October 2023

BackgroundThe gonio-endoscope is a novel device for use during minimally invasive glaucoma surgery (MIGS) to treat glaucomatous eyes with cloudy cornea. The MIGS procedure requires a surgical gonioprism lens for direct visualization of the angle, intraoperative manipulation of the surgical microscope and the patient’s head position, and the patient’s eye without a cloudy cornea. In cases with cloudy corneas or limitation of neck movement, MIGS cannot be safely performed. Gonio-endoscopy facilitates clear visualization of the trabecular meshwork (TM) to perform MIGS safely and easily even in a patient with corneal opacities or limitation of neck movement with no additional MIGS procedures. We report the first case in which we performed the newly developed a 10,000-pixel high-resolution 23-gauge gonio-endoscopic operation.Case presentationThe patient was a 58-year-old man with Down syndrome who had secondary glaucoma bilaterally after cataract surgery and long-time use of a steroid for atopic dermatitis and allergic conjunctivitis. His left eye had a cloudy cornea after penetrating keratoplasty for keratoconus with severe corneal residual scarring after prior resolved corneal hydrops. When the intraocular pressure (IOP) in his left eye increased to 41 mmHg despite the maximum use of anti-glaucoma eyedrops, he was referred to our hospital. Anterior-segment optical coherence tomography showed an open angle. We developed a new gonio-endoscope (MACHIDA Endoscope Co., Ltd., Chiba, Japan and NIPRO CORPORATION, Osaka, Japan), the probe of which is bent appropriately to aid visualization of and access to the TM. After obtaining clinical approval from the government and our institution, we could safely perform a high-resolution 23-gauge gonio-endoscopy-assisted microhook ab interno trabeculotomy (μLOT). The IOP decreased to 10 mmHg and the visual acuity has been preserved with no major complications for 1 year postoperatively.ConclusionThis new technique of clear gonio-visualization using a gonio-endoscope might be helpful for a safe and easy μLOT in patients with cloudy corneas. This device can apply to other types of MIGS procedures and cases with pathological diagnoses of glaucoma that are difficult to treat.
Effects of metformin on acute respiratory distress syndrome in preclinical studies: a systematic review and meta-analysis
Authors: Wang Liu , Tian Yan-Fen , Deng Wen-Qing 
Published: September 2023

Introduction: In this study, we conducted a systematic review and meta-analysis to judge the effects of metformin on acute respiratory distress syndrome (ARDS) in a comprehensive and quantitative manner.Methods: We included studies that tested the effects of metformin on ALI or ARDS in in vivo studies. We excluded literature from which data could not be extracted or obtained. Electronic search was conducted to retrieve relevant literature from public databases, including PubMed, Web of Science, Embase, Scopus, and the Cochrane Central Register of Controlled Trials (inception to July 2023). Moreover, ProQuest Dissertations and Theses Global, Google Scholar, and Baidu scholar were inquired. Retrieved literature was screened and evaluated by pairs of reviewers independently according to pre-stated criteria. The Systematic Review Center for Laboratory Animal Experimentation risk of bias tool was used to evaluate the methodological quality of eligible literature. No restriction was exerted on publication status or language.Results: Fifteen preclinical studies were analyzed in this meta-analysis. Pooled results showed metformin effectively decreased pulmonary wet-to-dry weight ratios [SMD = −2.67 (−3.53 to −1.81), I2 = 56.6%], protein content [SMD = −3.74 (−6.76 to −0.72), I2 = 86.7%] and neutrophils [SMD = −3.47 (−4.69 to −2.26), I2 = 0%] in BALF, pulmonary malondialdehyde [SMD = −1.98 (−3.77 to −0.20), I2 = 74.2%] and myeloperoxidase activity [SMD = −3.15 (−4.79 to −1.52), I2 = 74.5%], lung injury scores [SMD = −4.19 (−5.65 to −2.74), I2 = 69.1%], and mortality at 24 h [RR = 0.43 (0.24–0.76), I2 = 0%] as well as 48 and 72 h.Conclusion: Metformin inhibited pulmonary inflammation and oxidative stress and improved experimental lung injury and survival rates in animal models of ARDS. Results from randomized controlled trials are needed.
Access to COVID-19 testing by individuals with housing insecurity during the early days of the COVID-19 pandemic in the United States: a scoping review
Authors: Johannesson Jon M. , Glover William A. , Petti Cathy A. , Veldman Timothy H. , Tsalik Ephraim L. , Taylor Donald H. , Hendren Stephanie , Neighbors Coralei E. , Tillekeratne L. Gayani , Kennedy Scott W. , Harper Barrie , Kibbe Warren A. , Corbie Giselle , Cohen-Wolkowiez Michael , Woods Christopher W. , Lee Mark J. 
Published: September 2023

IntroductionThe COVID-19 pandemic focused attention on healthcare disparities and inequities faced by individuals within marginalized and structurally disadvantaged groups in the United States. These individuals bore the heaviest burden across this pandemic as they faced increased risk of infection and difficulty in accessing testing and medical care. Individuals experiencing housing insecurity are a particularly vulnerable population given the additional barriers they face. In this scoping review, we identify some of the barriers this high-risk group experienced during the early days of the pandemic and assess novel solutions to overcome these barriers.MethodsA scoping review was performed following PRISMA-Sc guidelines looking for studies focusing on COVID-19 testing among individuals experiencing housing insecurity. Barriers as well as solutions to barriers were identified as applicable and summarized using qualitative methods, highlighting particular ways that proved effective in facilitating access to testing access and delivery.ResultsUltimately, 42 studies were included in the scoping review, with 143 barriers grouped into four categories: lack of cultural understanding, systemic racism, and stigma; medical care cost, insurance, and logistics; immigration policies, language, and fear of deportation; and other. Out of these 42 studies, 30 of these studies also suggested solutions to address them.ConclusionA paucity of studies have analyzed COVID-19 testing barriers among those experiencing housing insecurity, and this is even more pronounced in terms of solutions to address those barriers. Expanding resources and supporting investigators within this space is necessary to ensure equitable healthcare delivery.