bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Exercise on the Cognitive Function of Older Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Authors: Cai Yi-Hui , Wang Zi , Feng Le-Yi , Ni Guo-Xin 
Published: April 2022

BackgroundAging and type 2 diabetes mellitus (T2DM) are important risk factors for the development of cognitive deterioration and dementia. The objective of this research was to investigate the effects of an exercise intervention on cognitive function in older T2DM patients.MethodsEight literature databases (PubMed, EBSCO, Scopus, Embase, The Cochrane Library, Web of Science, Ovid, and ProQuest) were searched from inception to 20 January 2022. The researchers examined randomized controlled trials (RCTs) that evaluated the impact of exercise on the cognitive performance of older T2DM patients. The Cochrane risk-of-bias tool (ROB 2) for RCTs was used to assess each study. The quality of evidence was assessed using the GRADE (grading of recommendations, assessment, development, and evaluations) approach. The mini-mental state examination (MMSE), Modified MMSE (3MSE), and Montreal cognitive assessment (MoCA) were used to evaluate the cognitive outcomes. We performed a subgroup analysis with stratification according to exercise intervention modality, duration, and cognitive impairment.ResultsFive trials were eligible, with a total of 738 T2DM patients. The combined findings revealed that exercise improved global cognitive function significantly (standardized mean difference: 1.34, 95% confidence interval: 0.23–2.44,p&lt; 0.01). The effect of exercise on global cognitive performance was not significantly influenced by intervention modality, intervention duration, or cognitive impairment in the sub-group analysis (p&gt; 0.05). In the studies that were included, no relevant adverse events were reported.ConclusionExercise is beneficial in improving global cognitive function in older adults with T2DM. Studies with bigger sample sizes and higher quality are additionally expected to draw more definite conclusions.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO/#recordDetails], identifier [CRD42022296049].
Efficacy of Dietary Supplements on Sleep Quality and Daytime Function of Shift Workers: A Systematic Review and Meta-Analysis
Authors: Wu Yeqi , Huang Xueyan , Zhong Congcong , Wu Ting , Sun Dai , Wang Rui , Zhan Qiang , Luo Huasong 
Published: April 2022

BackgroundDietary supplements (DSs) may be useful for managing shift work disorder. But the efficiency of outcomes in clinical trials using simulated shift work populations as subjects is controversial. This review explores the potential role of DSs for improving sleep quality, daily functioning, and mood among shift workers in the real world.MethodsA related literature search was conducted in PubMed, Web of Science, Embase, and Cochrane Library databases from their inception to July 2021. Information was collected on “shift work,” “irregular working hours,” “night shift,” “dietary supplements,” and “nutraceutical research data.” Sleep quality-related scales were the primary outcome measures. The meta-analysis was conducted using RevMan 5.4 (Cochrane Collaboration, London, England) and Stata 15.0 (StataCorp, LLC, College Station, TX, USA). Heterogeneity was examined by using I2 statistics, and publication bias was assessed via Egger's regression test.ResultsTwelve studies, which involved 917 participants, met the inclusion criteria. The DS groups had significant improvement in sleep quality scores (8 randomized controlled trials [RCTs]: p = 0.04; standard mean difference (SMD), −0.45 [−0.88 to −0.03]) and daytime function (7 RCTs: p = 0.02; SMD, −0.50 [−0.92 to −0.08]). The DS groups did not have a significant improvement in psychomotor vigilance (4 RCTs: p = 0.25; SMD, 0.52 [−0.36 to 1.41]), depression (5 RCTs: p = 0.14; SMD, −0.19 [−0.45 to 0.06]), or anxiety (4 RCTs: p = 0.27; SMD, −0.23 [−0.65 to 0.18]). All RCTs suggested a positive safety profile for DSs.ConclusionsThe findings of this meta-analysis indicated DSs may be beneficial for improving sleep quality and daytime function in shift workers. Although there is a wide range of DSs, the small amount of literature included for each type does not allow for subgroup analysis to be used to eliminate high heterogeneity. We have not yet included literatures on other languages either. Given these limitations of the study, there is still a need for more well-designed randomized controlled trials so that our review can be updated in the future to make the results more conclusive.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=273558, PROSPERO: CRD42021273558.
The Association of Thyroid Nodules With Blood Trace Elements Identified in a Cross-Section Study
Authors: Zeng Huixian , Hu Yuanyuan , Luo Yaosheng , Ye Yanshi , Song Cheng , Yu Genfeng , Chen Zhi , Liu Siyang , Liang Yongqian , Liu Lingling , Wan Heng , Shen Jie 
Published: April 2022

BackgroundThe association between occurrence of thyroid nodules (TNs) and trace elements detectable in blood are still inconclusive. The present study sought to determine the relationship between selected trace elements and TNs in the iodine-adequate area of Guangdong, China.MethodsA total of 1,048 participants from four communities were enrolled. A number of medical checkups were conducted to collect relevant data on anthropometric parameters, blood pressure, glucose blood levels and lipid profiles, as well as data on thyroid function, presence of thyroid autoantibodies, and trace elements. Presence of TN was diagnosed by ultrasonography.ResultsOf the 1048 participants (49.5 ± 14.4 years old), 543 participants (51.8%) had TNs. Serum copper, magnesium and zinc levels are associated with the presence of TNs among healthy subjects. Subjects with higher levels of zinc, magnesium and copper had 1.23-fold, 1.04-fold, and 1.007-fold increased risks of the prevalence of TNs (P = 0.013, 0.017, and &lt; 0.001, resp). Compared with the first quartile of copper content in serum, participants in the fourth quartile had the highest prevalence of TNs with an odds ratio of 8.90 (95% confidence interval (CI) 5.41, 14.94) among all participants. Women in the third quartile of magnesium level had a 1.86-fold (95%CI 1.05, 3.31) risk of the prevalence of TNs. Subjects in the highest quartile of zinc level had a 1.82-fold (95%CI 1.06, 3.16) risk of the prevalence of TNs in females.ConclusionTNs were found highly prevalent in females in the investigated population from an iodine-adequate area of Guangdong, China. The imbalance of selected trace elements (copper, magnesium and zinc) in the body is related to the presence of TNs among healthy subjects. The observed correlation of copper on TNs warrants further studies.
A Multi-Classification Model for Predicting the Invasiveness of Lung Adenocarcinoma Presenting as Pure Ground-Glass Nodules
Authors: Song Fan , Song Lan , Xing Tongtong , Feng Youdan , Song Xiao , Zhang Peng , Zhang Tianyi , Zhu Zhenchen , Song Wei , Zhang Guanglei 
Published: April 2022

ObjectivesTo establish a multi-classification model for precisely predicting the invasiveness (pre-invasive adenocarcinoma, PIA; minimally invasive adenocarcinoma, MIA; invasive adenocarcinoma, IAC) of lung adenocarcinoma manifesting as pure ground-glass nodules (pGGNs).MethodsBy the inclusion and exclusion criteria, this retrospective study enrolled 346 patients (female, 297, and male, 49; age, 55.79 ± 10.53 (24-83)) presenting as pGGNs from 1292 consecutive patients with pathologically confirmed lung adenocarcinoma. A total of 27 clinical were collected and 1409 radiomics features were extracted by PyRadiomics package on python. After feature selection with L2,1-norm minimization, logistic regression (LR), extra w(ET) and gradient boosting decision tree (GBDT) were used to construct the three-classification model. Then, an ensemble model of the three algorithms based on model ensemble strategy was established to further improve the classification performance.ResultsAfter feature selection, a hybrid of 166 features consisting of 1 clinical (short-axis diameter, ranked 27th) and 165 radiomics (4 shape, 71 intensity and 90 texture) features were selected. The three most important features are wavelet-HLL_firstorder_Minimum, wavelet-HLL_ngtdm_Busyness and square_firstorder_Kurtosis. The hybrid-ensemble model based on hybrid clinical-radiomics features and the ensemble strategy showed more accurate predictive performance than other models (hybrid-LR, hybrid-ET, hybrid-GBDT, clinical-ensemble and radiomics-ensemble). On the training set and test set, the model can obtain the accuracy values of 0.918 ± 0.022 and 0.841, and its F1-scores respectively were 0.917 ± 0.024 and 0.824.ConclusionThe multi-classification of invasive pGGNs can be precisely predicted by our proposed hybrid-ensemble model to assist patients in the early diagnosis of lung adenocarcinoma and prognosis.
What Are the Results of Limb Salvage Surgery for Primary Malignant Bone Tumor in the Forearm?
Authors: Liu Weifeng , Yang Yongkun , Jin Tao , Sun Yang , Li Yuan , Hao Lin , Zhang Qing , Niu Xiaohui 
Published: April 2022

Background and ObjectivesAfter diagnosing a primary bone tumor involving the forearm, various excision strategies and reconstruction methods must be considered. This study explored the oncological and functional outcomes of limb salvage surgery for primary malignant bone tumors in the forearm.MethodsPatients with primary forearm bone tumors (n = 369) were retrospectively analyzed between 2000 and 2017. There were 266 patients with radial tumors, and 46 (17.3%) were malignant, whereas 103 patients had ulnar lesions and 22 (21.4%) were malignant tumors. The oncological results, prognostic factors, and functional results after limb salvage surgery of forearm malignancies were analyzed.ResultsThe follow-up averaged 72.1 (7–192, median 62.5) months. Fifty-six patients who received limb salvage surgery were included in the final evaluation. Radius resection was performed in 38 patients, and distal radius (25 patients) was most frequent. Ulnar resection was performed in 18 patients, and the proximal ulna (13 patients) was most frequent. The surgical margins obtained were intralesional in 3 patients, marginal in 8 patients and wide in 45 patients. Local recurrence occurred in 11 patients (19.6%), and distant metastasis occurred in 14 patients (25%). The 5-year recurrence-free survival rate was 79.8%. Unplanned excision, ulnar involvement, proximal forearm location and inadequate surgical margins were associated with recurrence. The overall 5-year and 10-year survival rates were 83.5 and 71.7%, respectively. Distant metastasis was a poor prognostic factor for the survival rate. Forty-two patients were evaluated by MSTS score with an average of 27.9 ± 1.5.ConclusionsThe incidence of radial malignant tumors is higher than that of ulnar lesions. The distal radius and the proximal ulna are the most frequently involved sites. Unplanned excisions, ulnar tumors, proximal forearm tumors, and inadequate surgical margin are the risk factors for local recurrence. Distant metastasis is an independent poor prognostic factor of death. The oncology control and functional results of limb salvage surgery were satisfactory.
Correlation Between Early Time-to-Event Outcomes and Overall Survival in Patients With Locally Advanced Head and Neck Squamous Cell Carcinoma Receiving Definitive Chemoradiation Therapy: Systematic Review and Meta-Analysis
Authors: Black Christopher M. , Keeping Sam , Mojebi Ali , Ramakrishnan Karthik , Chirovsky Diana , Upadhyay Navneet , Maciel Dylan , Ayers Dieter 
Published: April 2022

BackgroundOverall survival (OS) is the most patient-relevant outcome in oncology; however, in early cancers, large sample sizes and extended follow-up durations are needed to detect statistically significant differences in OS between interventions. Use of early time-to-event outcomes as surrogates for OS can help facilitate faster approval of cancer therapies. In locally advanced head and neck squamous cell carcinoma (LA-HNSCC), event-free survival (EFS) was previously evaluated as a surrogate outcome (Michiels 2009) and demonstrated a strong correlation with OS. The current study aimed to further assess the correlation between EFS and OS in LA-HNSCC using an updated systematic literature review (SLR) focusing on patients receiving definitive chemoradiation therapy (CRT).MethodsAn SLR was conducted on May 27, 2021 to identify randomized controlled trials assessing radiotherapy alone or CRT in the target population. Studies assessing CRT and reporting hazard ratios (HRs) or Kaplan-Meier data for OS and EFS were eligible for the analysis. CRT included any systemic treatments administered concurrently or sequentially with radiation therapy. Trial-level EFS/OS correlations were assessed using regression models, and the relationship strength was measured with Pearson correlation coefficient (R). Correlations were assessed across all CRT trials and in trial subsets assessing concurrent CRT, sequential CRT, RT+cisplatin, targeted therapies and intensity-modulated RT. Subgroup analysis was conducted among trials with similar EFS definitions (i.e. EFS including disease progression and/or death as events) and longer length of follow-up (i.e.≥ 5 years).ResultsThe SLR identified 149 trials of which 31 were included in the analysis. A strong correlation between EFS and OS was observed in the overall analysis of all CRT trials (R=0.85, 95% confidence interval: 0.72-0.93). Similar results were obtained in the sensitivity analyses of trials assessing concurrent CRT (R=0.88), sequential CRT (R=0.83), RT+cisplatin (R=0.82), targeted therapies (R=0.83) and intensity-modulated RT (R=0.86), as well as in trials with similar EFS definitions (R=0.87), with longer follow-up (R=0.81).ConclusionEFS was strongly correlated with OS in this trial-level analysis. Future research using individual patient-level data can further investigate if EFS could be considered a suitable early clinical endpoint for evaluation of CRT regimens in LA-HNSCC patients receiving definitive CRT.
Efficacy and Safety Evaluation of Sintilimab for Cancer Treatment: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Ye Ziqi , Yang Wenchao , Xuan Bixia , Li Xiaofang , He Jiana , Si Haiyan , Ma Wenhua 
Published: April 2022

Objective: Meta analysis was used to explore the efficacy and safety of Sintilimab in the treatment of cancer.Methods: The databases of CNKI, VIP, Wanfang Data, PubMed, ScienceDirect, the Cochrane Library and EMBASE were searched by computer to collect the randomized controlled trials published as of March 2022. The retrieval work was completed by two researchers alone. They screened the literature and extracted the data according to the nanodischarge standard, using Revman 5.4 software. The included studies were statistically analyzed.Results: Six RCTs were included in this study, including 1,048 cases of Sintilimab and 711 cases of other anticancer drugs. Compared with the control group, the overall survival (HR = 1.64, 95% CI: 1.35–1.99, p &lt; 0.00001) and progression free survival (HR = 1.89, 95% CI: 1.59–2.25, p &lt; 0.00001) of cancer treated with Sintilimab were longer and more effective. Moreover, the risk ratio of any grade of adverse reactions (HR = 0.87, 95% CI: 0.74–1.03, p = 0.11) and above grade III adverse reactions (HR = 0.84, 95% CI: 0.67–1.06, p = 0.14) in the treatment of cancer with Sintilimab was lower and the safety was better.Conclusion: Compared with non-Sintilimab group, Sintilimab treatment can improve the clinical efficacy of tumor patients and has a lower incidence of adverse reactions. This treatment may be a promising treatment for cancer patients.
Osimertinib as Neoadjuvant Therapy for Resectable Non-Small Cell Lung Cancer: A Case Series
Authors: Hu Yan , Ren Siying , Yang Lulu , Tong Zhongyi , Wang Ruoyao , Han Wei , Zeng Chao , Li Jina , Xiao Peng , Wang Li , Yu Fenglei , Liu Wenliang 
Published: April 2022

Background: Evidence of osimertinib as neoadjuvant therapy for resectable non-small cell lung cancer (NSCLC) are currently lacking. This case series study aimed to assess the safety and feasibility of neoadjuvant osimertinib therapy followed by surgery for resectable NSCLC.Materials and methods: Patients with resectable NSCLC with epidermal growth factor receptor (EGFR) mutation who received osimertinib as neoadjuvant therapy followed by surgery at our center were included. Demographic features, radiologic and pathological assessment of response, surgery-related details and complications, toxicity profiles, and prognostic outcomes were extracted.Results: A total of 13 patients were included in this study. The median age at the time of surgical resection was 57 years (interquartile range: 52–64 years), and eight (61.5%) patients were female. The objective response rate (ORR) was 69.2% (9/13), and the complete resection rate was 100%. The rates of pathologic downstaging and lymph node downstaging were 100% (13/13) and 66.7% (6/9), respectively. There were no perioperative deaths and only three (23.1%) patients had postoperative complications. Seven (53.8%) and 13 (100%) patients experienced grade 1 treatment-related adverse reactions and laboratory abnormalities, respectively. No patients experienced drug withdrawal or surgical delays due to the adverse events. No patients showed grade 2 or worse toxicity profiles. One patient was lost to follow-up. The other 12 patients were alive and free of disease recurrence with a median follow-up time of 9.5 months.Conclusion: Neoadjuvant osimertinib therapy seemed to be safe and feasible for resectable EGFR-mutated NSCLC. Future large prospective studies are warranted to confirm whether osimertinib as neoadjuvant therapy outperforms standard tyrosine kinase inhibitors (TKIs) or chemotherapy for resectable EGFR-mutated NSCLC.
Detecting Volemic, Cardiac, and Autonomic Responses From Hypervolemia to Normovolemia via Non-Invasive ClearSight Hemodynamic Monitoring During Hemodialysis: An Observational Investigation
Authors: Lai Chih-Jun , Shih Chung-Chih , Huang Hsing-Hao , Chien Ming-Hung , Wu Ming-Shiou , Cheng Ya-Jung 
Published: April 2022

Background: Unstable hemodynamics are not uncommon during hemodialysis (HD), which involves a rapid volume depletion, taking the patient from hypervolemia toward euvolemia. Since uremic patients commonly have cardiovascular comorbidities, hemodynamic changes during HD may reflect interactions among the volemic, cardiac, and autonomic responses to gradual volume depletion during ultrafiltration. Accurate identification of inappropriate responses helps with precisely managing intradialytic hypotension. Recently, the non-invasive ClearSight was reported to be able to detect causes of intraoperative hypotension. In this prospective observational study, we aimed to determine whether ClearSight could be used to detect patterns in stroke volemic, cardiac, and vasoreactive responses during HD.Methods: ClearSight was used to monitor chronic stable patients receiving maintenance HD. Data of mean arterial blood pressure (MAP), heart rate (HR), stroke volume index (SVI), cardiac index (CI), and calculated systemic vascular resistance index (SVRI) were obtained and analyzed to examine patterns in volemic, cardiac, and vasoreactive changes from T0 (before HD) until T8 in 30-min intervals (total 4 h).Results: A total of 56 patients with a mean age of 60.5 years were recruited, of which 40 of them were men. The average ultrafiltration volume at T8 was 2.1 ± 0.8 L. The changes in MAP and HR from T0 to T8 were non-significant. SVI at T7 was significantly lower than that at T1, T2, and T3. CI at T4 to T8 was significantly lower than that at T0. SVRI was significantly higher at T3 to T8 than at T0. Pearson’s correlation coefficients between SVI and CI and between SVRI and MAP were positive at all time points. The correlation coefficients between SVRI and SVI and between CI and SVRI were significant and negative for all time points.Conclusion: ClearSight was able to detect patterns in hypervolemia during HD and was well tolerated for 4 h. CI decreased significantly after T4, with slightly decreased SVI. Ultrafiltration volume was not correlated with changes in SVI or CI. The vascular tone increased significantly, and this counteracted the reduced cardiac output after T4. With simultaneous monitoring on SVI, CI, and SVRI during HD, therefore, hypotension could be detected and managed by reducing the filtration rate or administering inotrope or vasopressors.Trial Registration:clinicaltrials.gov, ID: NCT03901794.
Hemoglobin Mass and Blood Volume in Patients With Altitude-Related Polycythemia
Authors: Schmidt Walter F. J. , Wachsmuth Nadine , Jimenez Jesus , Soria Rudy 
Published: April 2022

Patients with chronic mountain sickness (CMS) have a high hemoglobin concentration [Hb] due to increased hemoglobin mass (Hbmass) and possibly reduced plasma volume (PV). The values of Hbmass, PV and blood volume (BV) have been described differently, and the relationships between [Hb] and Hbmass or PV are poorly understood. This study obtained representative Hbmass, PV and BV data from healthy, high-altitude residents and CMS patients and quantified the dependency of [Hb] on Hbmass and PV. Methods: Eighty-seven subjects born at high altitude (∼3,900 m) were enrolled. Thirty-four had CMS (CMS), 11 had polycythemia without CMS (intermediate, IM), 20 were healthy highlanders (HH), and 22 living near sea level (SL, 420 m) served as the sea level (SL) control group. Hbmass, PV and BV were determined using a CO-rebreathing method modified for assessing polycythemia patients. Furthermore, [Hb], hematocrit (Hct), plasma erythropoietin concentration [EPO] and blood gas and acid–base status were determined. Results: In the HH group, Hbmass was 27% higher (940 ± 105 g) than in the SL group (740 ± 112 g) and 72% (1,617 ± 265 g) lower than in the CMS group. The PV in the HH group was similar to that in the SL group (−6%) and 15% higher than that in the CMS group (p &lt; 0.001). In the HH group, the BV (5,936 ± 673 ml) did not differ from that in the SL group and was 28% lower than in the CMS group (7,606 ± 1075 ml, p &lt; 0.001). Log [EPO] was slightly increased in the CMS group relative to the HH group (p &lt; 0.01). All values in the IM group were between those in the HH and CMS groups. Hbmass and BV were positively correlated, and PV was negatively correlated with peripheral O2 saturation. Increased Hbmass and decreased PV contributed approximately 65 and 35%, respectively, to the difference in [Hb] between the HH (17.1 ± 0.8 g/dl) and CMS (22.1 ± 1.0 g/dl) groups. Conclusions: In CMS patients, the decrease in PV only partially compensated for the substantial increase in Hbmass, but it did not prevent an increase in BV; the decrease in PV contributed to an excessively high [Hb].