bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of central sensitization on postoperative cognitive dysfunction in total knee arthroplasty patients: a retrospective study
Authors: Yang Qiqi , Li Chunning , Ye Min , Zhou Xinhua , Li Weiran , Li Fei 
Published: January 2025

BackgroundPostoperative cognitive dysfunction (POCD) is a common complication after total knee arthroplasty (TKA), impacting recovery and quality of life. This study aims to investigate central sensitization (CS) as an independent risk factor for POCD to improve preoperative screening and postoperative interventions.MethodsA retrospective analysis was conducted on 142 TKA patients from January 2020 to May 2024 across three hospitals. Data were collected at six time points: preoperatively (T0), intraoperatively (T1), and postoperatively on days 1 (T2), 3 (T3), 7 (T4), and 30 (T5). Patients were classified into CS (CSI ≥ 40) and non-CS (CSI &lt; 40) groups according to Central Sensitization Inventory (CSI) score. Cognitive function and POCD incidence were assessed with the Mini-Mental State Examination (MMSE), and knee recovery with the Knee Injury and Osteoarthritis Outcome Score (KOOS). Logistic regression was used to identified risk factors for POCD.ResultsThe overall incidence of POCD at T5 was 19.72%, with a significantly higher rate in CS group (30.91%) compared to non-CS group (12.64%) (p = 0.008). MMSE scores declined significantly in both groups at T2 and T3 compared to T0 (p &lt; 0.05), with CS group showing consistently lower scores than non-CS group at T2-T5 (p &lt; 0.05). KOOS scores revealed that CS group had worse pain and quality of life scores at T0, T4, and T5 compared with non-CS group (p &lt; 0.05). Logistic regression revealed that CS, cerebrovascular disease, intraoperative hemorrhage, and preoperative MMSE were associated with the risk of POCD (p &lt; 0.05).ConclusionCS is a significant risk factor for POCD following TKA, adversely affecting recovery in terms of pain and quality of life. Prospective studies are warranted to validate findings and develop targeted interventions.
Correlation of intracranial and extracranial carotid atherosclerotic plaque characteristics with ischemic stroke recurrence: a high-resolution vessel wall imaging study
Authors: Shao Shengyu , Wang Tianle , Zhu Li , Gao Yin , Fan Xian , Lu Yu , Qian Chengqun , Zhang Manyu , Qian Jinhua 
Published: January 2025

ObjectivesTo evaluate the ability of the plaque characteristics of extracranial carotid and intracranial arteries to predict large atherosclerotic ischemic stroke recurrence via head and neck combined high-resolution vessel wall imaging (HR-VWI).MethodsThis prospective cohort study included 169 patients with large atherosclerotic ischemic stroke who underwent head and neck combined HR-VWI from April 2022 to May 2023. The baseline clinical data and atherosclerotic plaque characteristics of the intracranial and extracranial carotid arteries were collected, and the patients were followed up for 1 year, with the endpoint event defined as recurrent ischemic stroke. Clinical and imaging data were compared between the recurrent and nonrecurrent groups. Independent risk factors associated with stroke recurrence were assessed via multivariate Cox regression analysis. The receiver operating characteristic (ROC) curves of the relevant variables were also plotted, and the area under the curve (AUC) was calculated to assess their ability to predict stroke recurrence. Kaplan–Meier survival curves were used to compare the probability of stroke recurrence.ResultsDuring the 12-month follow-up, stroke recurrence occurred in 35 of the 169 patients. Multivariate Cox regression analysis revealed that the total number of intracranial and extracranial carotid plaques (p = 0.010) and coexisting extracranial carotid plaques and intracranial significantly enhanced plaques (p = 0.047) were independent risk factors for recurrent ischemic stroke. The AUCs for predicting stroke recurrence were 0.787 and 0.710, respectively. The Kaplan–Meier survival curve revealed that the risk of stroke recurrence was significantly greater in patients whose total number of intracranial and extracranial carotid plaques was &gt;4.5 than in patients whose total number of plaques was &lt;4.5 (p &lt; 0.001) and was significantly greater in patients with coexisting extracranial carotid plaques and intracranial significantly enhanced plaques than in patients without coexisting plaques (p &lt; 0.001).ConclusionA greater total number of intracranial and extracranial carotid plaques and the coexistence of extracranial carotid plaques and intracranially significantly enhanced plaques are independent risk factors associated with recurrent ischemic stroke. Head and neck combined HR-VWI may provide new indicators for the prediction of stroke recurrence, thus helping clinicians identify high-risk patients and target therapy to reduce the recurrence of ischemic events.
Oral medications for the treatment of postural orthostatic tachycardia syndrome; a systematic review of studies before and during the COVID-19 pandemic
Authors: Pierson Benjamin C. , Apilado Kyle , Franzos M. Alaric , Allard Rhonda , Mancuso James D. , Tribble David , Saunders David , Koehlmoos Tracey Perez 
Published: January 2025

BackgroundPostural Orthostatic Tachycardia Syndrome (POTS) is a complex form of dysautonomia that presents with abnormal autonomic reflexes upon standing, leading to symptoms such as lightheadedness, tachycardia, fatigue, and cognitive impairment. The COVID-19 pandemic has brought renewed attention to POTS due to its overlap with post-acute sequelae of COVID-19 (PASC). Studies have found that a substantial percentage of COVID-19 survivors exhibit symptoms resembling POTS, elevating POTS diagnoses to previously unseen levels. We systematically reviewed the literature for existing high-quality evidence on potential interventions.MethodsA systematic review of the literature was performed to identify studies of oral medications for the management of POTS. We searched for published manuscripts on the medical management of POTS through 6 April 2024 which met pre-specified inclusion criteria. We conducted quality appraisal and assessed risk of bias before extracting the data and performing synthesis to determine the current state of the evidence; particularly in the context of PASC.ResultsThe study search and selection process identified 32 studies that met inclusion criteria, comprising randomized controlled trials, observational studies, and systematic reviews. Most included studies were judged to be of moderate to high quality, with largely low risk of bias. The most frequently studied medications were beta-blockers, ivabradine, and midodrine. Ivabradine and midodrine demonstrated the highest rate of symptomatic improvement, while beta-blockers showed the largest reduction in heart rate variability. Limited evidence was available for PASC-associated POTS, but findings suggest that treatments may have similar efficacy in both PASC and non-PASC cases.ConclusionIvabradine, midodrine, and beta-blockers currently appear to be reasonable front-line choices in pharmacologic management of POTS (PASC associated and otherwise). Further RCTs that evaluate long term outcomes of medications are needed to further establish evidence based pharmacologic treatment approaches for POTS. Particular areas of inquiry include differential efficacy of recommended therapies based on POTS subtypes, and a need for treatments directly targeting the underlying autonomic nervous system dysfunction.Systematic review registrationPROSPERO, identifier CRD42024505967, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=505967.
Association between controlling nutritional status score and the prognosis of patients with acute myocardial infarction: a systematic review and meta-analysis
Authors: Peng Lei , Tang Jian , Zhang Ningjun , Zhang Zhongnan , Wang Deqi , He Youfu 
Published: January 2025

BackgroundRecent studies have reported growing evidence supporting applying the controlling nutritional status (CONUT) score in acute myocardial infarction (AMI) patients. This investigation intended to ascertain the link between CONUT scores and the prognosis in the AMI population.MethodsMultiple electronic databases, encompassing PubMed, Web of Science, Embase, and the Cochrane Library, were retrieved from the inception of the databases until July 20, 2024, to explore the link between CONUT scores and adverse clinical outcomes in individuals with AMI. Primary outcomes consisted of major adverse cardiovascular events (MACE) and mortality, while secondary outcomes encompassed stroke, cardiac death, myocardial reinfarction, revascularization, ventricular arrhythmias, and atrioventricular block. A random-effects meta-analysis was executed, with CONUT scores treated as either categorical or continuous variables. Sensitivity analyses and Egger’s test were conducted to appraise the robustness of results and publication bias, respectively. Subgroup analyses were executed to account for various confounding factors. Moreover, the GRADE system was leveraged to appraise the quality of evidence for all outcomes.ResultsFifteen studies were included in our analysis. The statistical analyses on both categorical and continuous variables unraveled that a high CONUT score was markedly linked to an elevated risk of MACE [categorical variable: odds ratio (OR) = 1.75, 95% confidence interval (CI) = 1.42–2.15; continuous variable: standardized mean difference (SMD) = 1.02, 95% CI = 0.78–1.26], mortality (categorical variable: OR = 2.08, 95% CI = 1.70–2.55; continuous variable: SMD = 1.16, 95% CI = 0.57–1.74), cardiac death (categorical variable: OR = 2.81, 95% CI = 1.67–4.73), myocardial reinfarction (categorical variable: OR = 2.21, 95% CI = 1.28–3.83), and atrioventricular block (categorical variable: OR = 5.21, 95% CI = 1.83–14.89) in AMI patients. However, no significant association was found between a high CONUT score and stroke (categorical variable: OR = 1.52, 95% CI = 0.98–2.35), revascularization (categorical variable: OR = 2.92, 95% CI = 0.58–14.79), and ventricular arrhythmias (categorical variable: OR = 2.57, 95% CI = 0.06–107.21).ConclusionThe CONUT score may serve as a promising and cost-effective prognostic biomarker for individuals with AMI.Systematic review registrationPROSPERO: CRD42024574048.
Association between oxidative balance score and all-cause, CVD and respiratory-related mortality in the US older adults of asthma patients with diabetes
Authors: Liu Chang , Liang Dan , Xiang Guoan , Zhao Xuanbo , Xiao Kun , Xie Lixin 
Published: January 2025

BackgroundThis study aims to investigate the correlation between oxidative balance score (OBS) and all-cause, cardiovascular disease (CVD) and respiratory-related mortality within a cohort that includes older asthma patients with diabetes.MethodsData from the National Health and Nutrition Examination Survey (NHANES) spanning from 2001 to 2018, which included 611 participants, were analyzed. Mortality outcomes were determined by linking the data to National Death Index (NDI) records through December 31, 2019. Cox regression modeling was employed to examine the relationship between OBS and all-cause, CVD and respiratory-related mortality. Restricted cubic splines (RCS), subgroup analyses and interaction tests were also conducted in this study.ResultsOver a median follow-up of 78.96 months, there were 216 all-cause deaths and 57 CVD-related deaths. A significant negative association was found between the OBS and all-cause and CVD mortality. We did not observe OBS could reduce respiratory-related mortality in older asthma patients with diabetes. RCS analysis indicated a linear and inverse association between the OBS and all-cause and CVD mortality. Subgroup analyses and interaction tests indicated the negative association between OBS and CVD mortality was significantly influenced by alcohol consumption.ConclusionIn this sample, higher OBS was associated with lower all-cause and CVD mortality risks. These findings stressed the importance of infection status in assessing oxidative balance’s impact on health.
Different surgical methods of hysterectomy for the management of endometrial cancer: a systematic review and network meta-analysis
Authors: Yuan Yuquan , Tan Qin , Chen Yingfan , Zhu Keyang , Pan Bin , Liu Bao , Ren Chunyan , Li Ganghui , Chen Cheng , Zhao Chengzhi 
Published: January 2025

BackgroundEmerging surgical methods are utilized to treat endometrial cancer. The study aimed to assess the efficacy and safety of four common surgical methods of hysterectomy.MethodsWe systematically searched the PubMed, Cochrane Library databases, Medline, EMBASE and Web of Science from their inception until April 30, 2024. We used hazard ratios (HR) for overall survival (OS) and disease-free (DFS), odds ratios (OR) for categorical outcomes, and mean differences (MD) for continuous outcomes with 95% confidence intervals. These were pooled in Bayesian network meta-analysis models. The surface under the cumulative ranking curve (SUCRA) was used to illuminate the probability that each method would be the best for each outcome.ResultsThirty studies comprising 13446 patients were included. Robotic hysterectomy (RH) retrieved fewer pelvic lymph nodes than open hysterectomy (OH). OH showed a significantly higher postoperative complication rate than laparoscopic hysterectomy (LH) and RH. LH had a higher intraoperative complication rate than OH. According to SUCRA values, OH ranked the highest in the number of retrieved pelvic lymph nodes (0.89), intraoperative complications (0.73), and operative time (0.97). LH ranked the highest in DFS (0.81) and overall survival (OS) (0.87). RH ranked the highest in the postoperative complications (0.95). Laparoscopic-assisted vaginal hysterectomy (LAVH) ranked the highest in number of retrieved para-aortic lymph nodes (0.72).ConclusionsThere are no significant differences among the four surgical methods in DFS or OS. The use of uterine manipulators does not affect prognosis. OH is the best method for shortening operative time, dissecting the pelvic lymph nodes and controlling intraoperative complications. LH and LAVH have an advantage in para-aortic lymph node dissection. Besides, LH has the best advantage in DFS and OS. RH has advantages in controlling surgical complications.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024529974.
Adding capivasertib to fulvestrant in patients with hormone receptor-positive advanced breast cancer: a cost-effectiveness analysis
Authors: Lang Yitian , Chai Qingqing , Lin Yan , Wu Bin , Liu Xiaoyan 
Published: January 2025

ObjectiveCapivasertib, a novel pan-AKT inhibitor, shows significant antitumor activity against hormone receptor-positive advanced breast cancer. However, its cost-effectiveness of this treatment remains uncertain. This study aimed to evaluate the cost-effectiveness of capivasertib plus fulvestrant versus fulvestrant alone for advanced breast cancer treatment from the perspectives of healthcare payers in the United States. Meanwhile, a experimental analysis from the perspective of China, incorporating specific assumptions, was also conducted in this study.MethodsA partitioned survival model was constructed to project the progression of breast cancer. Overall survival (OS) and progression-free survival (PFS) data were obtained from the CAPItello-291 trial and extrapolated for long-term survival estimates. Direct medical costs and utility data were gathered. The primary outcome measure was incremental cost-utility ratio (ICUR) to evaluate the cost-effectiveness of treatment regimen. One-way sensitivity analyses (OWSA) and probabilistic sensitivity analyses (PSA) were conducted to assess the robustness of the results.ResultsThe base-case analysis estimated the ICUR for capivasertib plus fulvestrant versus fulvestrant alone to be $709,647 per quality-adjusted life-year (QALY) in the US. OWSA revealed that the results were sensitive to hazard ratio of OS and the cost of capivasertib. PSA demonstrated that capivasertib plus fulvestrant exhibited a 0% probability of cost-effectiveness in the US.ConclusionOur finding suggests that, at its current price, capivasertib plus fulvestrant regimen is unlikely to be a cost-effective option compared to fulvestrant alone for HR-positive advanced breast cancer patients from the perspective of healthcare system in the US. For the experimental analysis based on specific assumptions from Chinese perspective, the therapy regimen was also found to lack cost-effectiveness.
Effect of prophylactic doses of enoxaparin on antifactor Xa activity confirmed by rotational thromboelastometry in critically ill patients: a preliminary prospective cohort study
Authors: Czempik Piotr F. , Beberok Artur 
Published: January 2025

IntroductionCritically ill patients present multiple risk factors for venous thromboembolism (VTE). Underdosing of antithrombotic medications can result in VTE even as bleeding remains a significant concern for critically ill patients. On the other hand bleeding, remaining a significant concern for the critically ill, can be worsend by overdosing of antithrombotic medications. The present study aimed to assess the effects of prophylactic doses of enoxaparin on antifactor Xa activity (anti-Xa) and rotational thromboelastometry (ROTEM) parameters in critically ill patients.Materials and methodsIn this prospective single-center cohort study, the effects of enoxaparin were assessed via anti-Xa monitoring. Standard laboratory coagulation and ROTEM parameters were also determined using the same blood samples.ResultsA total of 61 patients (42.6% women) were enrolled in this study, whose median age was 59.0 (interquartile range: 43.0–70.0) years. Based on anti-Xa, the effects of enoxaparin were normal in 35 subjects (57.4%); in 17 patients (27.9%), the anti-Xa troughs and/or peaks were higher than the prophylactic range; in 9 patients (14.7%), the anti-Xa peak was lower than the prophylactic range. There were differences among the anti-Xa groups with respect to some ROTEM parameters. No VTE was detected among the study subjects. In 3 subjects (4.9%), there were signs of bleeding, and these patients presented with longer thrombin times.ConclusionAnti-Xa values may be within the prophylactic range in slightly more than half of the critically ill patients receiving enoxaparin at prophylactic doses. The dosing of low-molecular-weight heparin (LMWH) in critically ill patients may require individualization based on anti-Xa. Further studies are therefore required to establish a universal anti-Xa prophylactic range for LMWH, the timing of anti-Xa determination, and management of LMWH dosing.
Oxyresveratrol as a novel ferroptosis inducer exhibits anticancer activity against breast cancer via the EGFR/PI3K/AKT/GPX4 signalling axis
Authors: Xiang Lei , Li Qingzhou , Guan Zhiwei , Wang Guilin , Yu Xiankuo , Zhang Xianwen , Zhang Guochen , Hu Jushan , Yang Xue , Li Mingrui , Bao Xilinqiqige , Wang Yumei , Wang Dong 
Published: January 2025

IntroductionOxyresveratrol (ORes) exhibits significant anticancer activity, particularly against breast cancer. However, its exact mechanism of action (MOA) remains unclear. This study aimed to investigate the pharmacological activity and underlying MOA.MethodsThe inhibitory effect of ORes on breast cancer cell growth was confirmed, and the effective concentrations were determined for further experiments. Gene expression profiles (GEPs) were collected from MDA-MB-231 cells treated with ORes at varying concentrations using HTS2. Bioinformatics tools were used to predict the anticancer activity and MOA of ORes. Ferroptosis markers (ferrous ions, reactive oxygen species, lipid peroxidation, and GPX4 expression) were assessed, and mitochondrial morphology was observed. The effect of ORes on tumour growth was evaluated in vivo, along with the analysis of ferroptosis in tissues. The MOA was explored using L1000, Drug Gene DataBase (DGDB), and Western blotting analyses.ResultsORes significantly reduces breast cancer cell viability and proliferation in a concentration-dependent manner, with IC50 values of 104.8 μM, 150.2 μM, and 143.6 μM in MDA-MB-231, BT-549, and 4T1 cells, respectively. GEPs induced by ORes were significantly enriched in the ferroptosis and PI3K/AKT signalling pathways. ORes inhibited breast cancer cell growth, increased intracellular ferrous ion levels, reactive oxygen species, and lipid peroxidation, and induced ferroptosis-related mitochondrial alterations. These effects were associated with decreased GPX4 expression and suppression of EGFR, phosphorylated PI3K, and phosphorylated AKT. ORes inhibited tumour growth, enhanced iron deposition, and reduced GPX4 expression in tumour tissues in vivo. Notably, treatment with the ferroptosis inhibitor ferrostatin-1 (Ferr-1) attenuated the anticancer effects of ORes, confirming the pivotal role of ferroptosis in ORes-mediated breast cancer inhibition.ConclusionORes inhibits breast cancer cell growth by inducing ferroptosis through suppression of the EGFR/PI3K/AKT/GPX4 signalling axis. This study suggests that ORes holds promise as a potential therapeutic agent for breast cancer and warrants further investigation into its clinical applications and potential integration into existing treatment regimens.
Improving sensory integration in Chinese children with moderate sensory integration challenges through engaging basketball training
Authors: Ge Sha , Guo Xuepeng , Jiang Bo Y. , Cordova Alberto , Guan Jianmin , Zhang John Q. , Yao Wan X. 
Published: January 2025

ObjectiveThis study aimed to evaluate the effectiveness of combining basketball training with a traditional sensory integration therapy (SIT) vs. a SIT alone in enhancing sensory integration capability among Chinese children diagnosed with mild challenges in sensory integration and sensory processing (CSISP).MethodsThis study comprised a Control group and an Experimental group, both undergoing a 10-week intervention (4 sessions/week, 45 min/session). The Control group exclusively participated in traditional SIT for all sessions. In contrast, the Experimental group engaged in traditional SIT for two sessions per week and Basketball training for the remaining two sessions weekly. Three sensory integration measures (vestibular sensation, tactile perception, proprioception) and five gross motor performance measures (balance beam walking speed, single-leg standing with eyes closed, tennis ball throw, two-legged jump speed, 10-m shuttle run) were assessed before and after the 10-week training period. Separate 2 (Group) × 2 (Test Phases) Analysis of Variance (ANOVA) with repeated measures on the second factor were conducted for each measure. Interaction effects were further explored using Tukey's HSD test to clarify their nature.ResultsBoth groups demonstrated significant improvements in all sensory integration and gross motor performance measures following the 10-week training sessions (p &lt; 0.001). Importantly, the group receiving the combination of basketball training and traditional SIT significantly outperformed the group undergoing SIT alone in all assessed areas.ConclusionThese results indicate that combining basketball training with traditional SIT enhances sensory integration capabilities more effectively among Chinese children aged 4–6 years with moderate CSISP compared to utilizing SIT alone.