bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Serum Adipokines and Resting Energy Expenditure in Patients With Chronic Kidney Disease
Authors: Abi Nanzha , Xu Xiao , Yang Zhikai , Ma Tiantian , Dong Jie 
Published: March 2022

Background and AimMetabolic disorders are prevalent in patients with chronic kidney disease (CKD) and may lead to protein energy wasting (PEW). Adipokines improve connections between PEW and energy metabolism. We aimed to determine the relationship between adipokine levels and resting energy expenditure (REE) in patients with CKD.MethodsA total of 208 patients in non-dialyzed CKD stages 3–5 were enrolled in this cross-sectional study. Serum adipokines (leptin, adiponectin, and interleukin 6 (IL-6) were measured using enzyme-linked immunosorbent assay. Patient's REE was measured using indirect calorimetry. Fat mass (FM) and lean tissue mass (LTM) were measured using multiple-frequency bioimpedance analysis. Spearman correlation analyses and multivariate linear regression models were used to assess the association between serum adipokines and REE.ResultsThe mean age was 52.7 ± 14.6 years, and 26.9, 26.4, and 46.7% of our participants had CKD stages 3, 4, and 5, respectively. The median values of serum adiponectin, leptin, and IL-6 were 470.4 (range, 291.1–802.2), 238.1 (range, 187.9–418.4), and 4.0 (range, 2.4–9.5) pg/mL, respectively. The male participants had significantly lower FM% (P = 0.001) and lower leptin levels (P &lt; 0.001) than the female participants. After adjusting for age, diabetes, high-sensitivity C-reactive protein, intact parathyroid hormone, LTM, and FM, multiple linear regression analysis revealed that serum leptin levels were significantly positively associated with REE in men rather than in women (P &lt; 0.05). Serum adiponectin levels were inversely associated with REE in men, but this association disappeared while FM was additionally adjusted. Adiponectin levels in women were not correlated with REE (P &gt; 0.05). IL-6 was not significantly associated with REE in either men or women.ConclusionsA sex-specific relationship between serum adipokines (leptin and adiponectin) and REE was observed in patients with CKD stages 3–5, which was partly confounded by FM.
Three Nutritional Indices Are Effective Predictors of Mortality in Patients With Type 2 Diabetes and Foot Ulcers
Authors: Hong Jing , Huang Qi-Qi , Liu Wen-Yue , Hu Xiang , Jiang Fei-Fei , Xu Ze-Ru , Shen Fei-Xia , Zhu Hong 
Published: March 2022

IntroductionMalnutrition has been associated with mortality in various diseases. This retrospective cohort study aimed to investigate the relationship between three nutritional indices and all-cause mortality in patients with diabetic foot ulcers (DFUs).Materials and MethodsA total of 771 patients diagnosed with DFUs in the First Affiliated Hospital of Wenzhou Medical University from 2015 to 2019 were included in this retrospective cohort study. Patients were classified as high nutritional risk groups or low nutritional risk groups according to the optimal cut-off values of the geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and controlling nutritional status (CONUT), respectively. The associations of three nutritional indices with all-cause mortality were evaluated by multivariable Cox regression analyses.ResultsLog-rank tests indicated that patients with high nutritional risk had lower overall survival rates (all p &lt; 0.001). The multivariable Cox regression revealed that low GNRI (adjusted HR 2.01, 95% CI: 1.37–2.96, P &lt; 0.001), low PNI (adjusted HR 2.04, 95% CI: 1.29–3.23, P = 0.002) and high CONUT (adjusted HRs 1.54, 95% CI: 1.07–2.23, P = 0.021) were independently associated with high all-cause mortality. In subgroup analyses, only GNRI predicted higher all-cause mortality in patients with severe DFUs, while all of the three indices persisted as independent prognostic factors in patients with no severe DFUs.DiscussionThe present study demonstrated that three nutritional indices were effective predictors of all-cause mortality in patients with DFUs. Routine screening for malnutrition using any of the three nutritional indices might be a simple and effective way to identify high-risk patients with DFUs. GNRI can be used as an independent prognostic indicator in patients with severe DFUs.
Associations of Dietary Copper, Selenium, and Manganese Intake With Depression: A Meta-Analysis of Observational Studies
Authors: Ding Jun , Zhang Yi 
Published: March 2022

ObjectiveTo comprehensively summarize the evidence on the associations of dietary copper, selenium, and manganese intake with depression based on a meta-analysis of observational studies.MethodsThe electronic database of PubMed, Web of Science, and Embase were searched up to January 7, 2022, for observational studies on the associations of dietary copper, selenium and manganese intake with depression (no restriction was set for the initiate time). The pooled relative risk (RR) of depression for the highest vs. lowest dietary copper, selenium, and manganese intake category were calculated.ResultsA total of 11 observational studies (61,430 participants) were identified as meeting the inclusion criteria. Specifically, five studies were related to the dietary copper intake. The overall multi-variable adjusted RR demonstrated that dietary copper intake was inversely associated with depression (RR = 0.63, 95% CI: 0.52–0.76; P &lt; 0.001; I2 = 2.4%). With regard to the dietary selenium intake, six studies were identified for meta-analysis. The overall multi-variable adjusted RR showed that dietary selenium intake was also negatively associated with depression (RR = 0.63, 95% CI: 0.54–0.74; P &lt; 0.001; I2 = 37.8%). In addition, four studies were specified for the dietary manganese intake, and the overall multi-variable adjusted RR indicated a negative relationship between dietary manganese intake and depression (RR = 0.71, 95% CI: 0.58–0.86; P &lt; 0.001; I2 = 0.0%).ConclusionsOur results suggest a negative relationship between dietary copper, selenium and manganese intake and depression, respectively. However, due to the limited prospective evidence, our results are restricted to cross-sectional design that precludes causal relationships. More well-designed prospective cohort studies are still needed.
Comparative Efficacy of Tonic Chinese Herbal Injections for Treating Sepsis or Septic Shock: A Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials
Authors: Xiao Lu , Niu Liqing , Xu Xinyi , Zhao Yuetong , Yue Linkai , Liu Xinqiao , Li Guiwei 
Published: March 2022

Background: Sepsis has high mortality and is responsible for significant healthcare costs. Chinese herbal injections (CHIs) have been widely used in China as a novel and promising treatment option for sepsis. Therefore, this study assessed and ranked the effectiveness of CHIs to provide more sights for the selection of sepsis treatment.Method: Eight databases were searched from their inception up to September 1, 2021. The methodological quality of included study was evaluated by the Revised Cochrane risk-of-bias tool for randomized trials. Then Bayesian network meta-analysis was performed by OpenBUGS 3.2.3 and STATA 14.0 software. The surface under the cumulative ranking curve (SUCRA) probability values were applied to rank the examined treatments. Publication bias was reflected by a funnel plot.Results: A total of 50 eligible randomized controlled trials involving 3,394 participants were identified for this analysis. Five CHIs including Shenfu injection, Shenmai injection, Shengmai injection, Shenqifuzheng injection, and Huangqi injection were included. The results of the NMA and sensitivity analysis showed that Shenqifuzheng (MD = −4.48, 95% CI = −5.59 to −3.24), Shenmai (MD = −3.38, 95% CI = −4.38 to −2.39), Shenfu (MD = −2.38, 95% CI = −3.03 to −1.70) and Shengmai (MD = −1.90, 95% CI = −3.47 to −0.31) combined with Western medicine (WM) had a superior effect in improving the APACHE II score. Based on SUCRA values, Shenqifuzheng injection (95.65%) ranked highest in the APACHE II score, followed by Shenmai (74%), Shenfu (47.1%), Shengmai (35.3%) and Huangqi injection (33.2%). Among the secondary outcomes, Shenmai injection was the most favorable intervention in reducing PCT and CRP levels, and Shenqifuzheng injection was the second favorable intervention in reducing CRP level. Shenfu injection combined with WM was more effective than the other treatments in decreasing the serum IL-6 and TNF-α levels and lowering the 28-days mortality. Regarding the improvement of immune function, Shenqifuzheng injections had obvious advantages.Conclusion: In conclusion, Shenqifuzheng injection was the optimum treatment regimen to improve APACHE II score, reduce CRP level, and regulate immune function. Shenfu injection was superior in reducing the expression of inflammatory factors and decreasing 28-days mortality. Nevertheless, more multicenter, diverse, and direct comparisons randomized controlled trials are needed to further confirm the results.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=254531, identifier CRD42021254531.
A Systematic Review of Utilisation of Diurnal Timing Information in Clinical Trial Design for Long QT Syndrome
Authors: Seed Lydia M. , Hearn Timothy J. 
Published: March 2022

Diurnal oscillations in human cardiac electrophysiology are thought to be under the control of the endogenous circadian clock. The incidence of arrhythmic events in patients with Long QT syndrome (LQTS) varies diurnally. The diurnal variation in QT interval has previously been identified as a potential for error in clinical trials which utilise ECG measurement. We performed a systematic review of clinical trials for LQTS to identify practice around specification of timing information for point electrocardiogram (ECG) measurements, analysis of continual ECG recordings ≥24 h, and drug delivery. Despite guidelines having been issued around the analysis of 24-h ECG recordings, we identify a lack of usage of detailed time of day information in trial design for LQTS studies, which has the potential to affect the interpretation of the results of drug trials. We identify that, in contrast, clinical trials for QT prolonging drugs demonstrate increased incorporation of time of day information of both QT analysis and drug dosing. We provide a visual portal to allow trial designers and clinicians to better understand timing of common cardiac-targeting drugs, and to bear this concept in mind in the design of future clinical trials.
A Bibliometric Analysis of the Landscape of Problem-Based Learning Research (1981–2021)
Authors: Zhang Fan , Wang Hui , Bai Yan , Zhang Huachun 
Published: March 2022

BackgroundProblem-Based Learning (PBL) is an instructional method of hands-on, active learning centered on investigating and resolving messy, real-world problems. This study aims to systematically analyze the current status and hotspots of PBL research and provide insights for research in the field.MethodsProblem-based learning-related publications were retrieved from the Web of Science Core Collection using “Problem-Based Learning”. Annual publications, countries, institutions, authors, journals, references, and keywords in the field were visually analyzed using the R, VOSviewer, and Microsoft Excel 2019 software.ResultsA total of 2,790 articles and reviews were analyzed, with a steady increase in publications in the field of PBL. Overall, the United States was the major contributor to the study of PBL. Van Der Vleuten CPM was the key researcher in this field. Moreover, most of the publications were published in Medical Education. Keyword analysis showed that current research hotspots focus on the extensions of PBL teaching mode, application of PBL teaching method, and reform of PBL.ConclusionResearch on PBL is flourishing. Cooperation and exchange between countries and institutions should be strengthened in the future. These findings will provide a better understanding of the state of PBL research and inform future research ideas.
Association Between Fatigue and Falls Risk Among the Elderly Aged Over 75 Years in China: The Chain Mediating Role of Falls Efficacy and Lower Limb Function
Authors: He Yudi , Zhang Huaguo , Song Mi , Wu Hongyi , Pi Hongying 
Published: March 2022

BackgroundAlthough fatigue has been shown to be strongly associated with falls risk, very few studies have focused on its mechanism involved in community-dwelling older subjects. The purpose of this study was to explore the relationship between fatigue and falls risk and its internal mechanism by constructing a chain mediation model.MethodsA cross-sectional study design was adopted. A convenience sample of 270 older adults was recruited from July to October 2021 in an urban community, in Beijing, China. The participants completed the 14-item Fatigue Scale (FS-14), Falls Efficacy Scale International (FES-I), the Short Physical Performance Battery (SPPB) and Fall-Risk Self-Assessment Questionnaire (FRQ) to measure fatigue, falls efficacy, lower limb function and falls risk. The theory of unpleasant symptoms was used as a conceptual framework. Structural equation modeling (SEM) was utilized to test the hypothetical model.ResultsThe overall fit of final model was found to be satisfactory: χ2/df = 1.61, CFI = 0.971, TLI = 0.962, RMSEA = 0.049 (95% CI 0.030/0.066) and SRMR = 0.023. Fatigue had a direct effect on falls risk (β = 0.559, S.E. = 0.089, 95% CI 0.380/0.731), and it also had indirect effects on falls risk (β = 0.303, S.E. = 0.072, 95% CI 0.173/0.460) through mediating factors. Falls efficacy and lower limb function were the main mediating variables, and there was a chain mediating effect (β = 0.015, S.E. = 0.010, 95% CI 0.003/0.046).ConclusionsOur study suggests that fatigue can influence falls risk among the elderly in China. There are many mediating paths between fatigue and falls risk. These results may help healthcare professionals to better understand the inherent relationship between fatigue and fall risk that may benefit older adults.
Can the Ratio SUVmax of the Lesion/SUVmax of Mediastinal Tissues Guide the Choice of Surgical Access for the Resection of Thymic Epithelial Tumors?
Authors: Moraitis Sotirios D. , Agrafiotis Apostolos C. , Skoura Evangelia , Kalkanis Dimitrios , Moraitis Dimitrios , Tomos Periklis , Liakakos Theodoros , Angouras Dimitrios 
Published: March 2022

BackgroundThere are studies showing the utility of the 18-fluorodeoxyglucose positron emission tomography (18FDG PET) scan in the management of patients with thymic epithelial tumors. It seems to be a correlation between the standard uptake value (SUVmax) of thymic epithelial tumors and the histological type and the stage. This study aims to use the ratio of the SUVmax of the lesion to the SUVmax of the adjacent mediastinal tissues in order to guide the choice of the surgical access.MethodsAll patients who presented an anterior mediastinal lesion with a high suspicion of being of thymic origin were included in a prospective database. A ratio inferior to 1 could predict a benign nature and less aggressive behavior, and a minimally invasive approach was performed. A ratio superior to 1 suggested a malignant and aggressive behavior, and a median sternotomy (or a thoracotomy) was performed.ResultsThere were 15 male (mean age 44.6 ± 16.26 years, range 25–73) and 15 female patients (mean age 50.1 ± 16.94 years, range 25–76). When the ratio is inferior to 1, it predicts benign disease in 80% of cases. When it is superior to 1, it predicts in half of cases advanced histological types (high risk thymomas and thymic carcinomas). On the contrary, it can quite accurately predict advanced Masaoka–Koga stages.ConclusionsThe protocol of this study is in accordance with the current literature showing the utility of 18FDG PET scan in the treatment of thymic epithelial tumors. This study goes one step further since the choice of surgical access is based on the SUVmax values. The ratio SUVmax of the lesion/SUVmax of the mediastinal tissues could be a new marker, more pertinent than absolute SUVmax values.
Survival After Lobectomy vs. Sublobar Resection for Stage IA Large-Cell Neuroendocrine Carcinoma of the Lung: A Population-Based Study
Authors: Yu Xiangyang , Zhang Mengqi , Wang Feifei , Guo Xiaotong , Ma Kai , Wang Lixu , Zhao Hongbo , Xiao Hua , Huang Chujian , Du Longde , Jia Ran , Yang Yikun , Zhang Lanjun , Yu Zhentao 
Published: March 2022

ObjectiveDue to the low incidence of pulmonary large cell neuroendocrine carcinoma (LCNEC), the survival analysis for comparing lobectomy and sublobar resection (SLR) for stage IA LCNEC remains scarce.MethodsPatients diagnosed with pathological stage IA LCNEC between 1998 and 2016 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The oncological outcomes were cancer-specific survival (CSS) and overall survival (OS). Kaplan–Meier analysis and Cox multivariate analysis were used to identify the independent prognostic factors for OS and CSS. Furthermore, propensity score matching (PSM) was performed between SLR and lobectomy to adjust the confounding factors.ResultsA total of 308 patients with stage IA LCNEC met the inclusion criteria: 229 patients (74.4%) received lobectomy and 79 patients (25.6%) received SLR. Patients who underwent SLR were older (P &lt; 0.001), had smaller tumor size (P = 0.010), and less lymph nodes dissection (P &lt; 0.001). The 5-year CSS and OS rates were 56.5 and 42.9% for SLR, and 67.8 and 55.7% for lobectomy, respectively (P = 0.037 and 0.019, respectively). However, multivariate analysis did not identify any differences between the SLR group and lobectomy group in CSS (P = 0.135) and OS (P = 0.285); and the PSM also supported these results. In addition, the age at diagnosis and laterality of tumor were identified as significant predictors for CSS and OS, whereas the number of lymph nodes dissection was a significant predictor for CSS.ConclusionsAlthough SLR is not inferior to lobectomy in terms of oncological outcomes for patients with stage IA LCNEC, more lymph nodes can be dissected or sampled during lobectomy. Lobectomy should still be considered as a standard procedure for patients with early-stage LCNEC who are able to withstand lobectomy.
Influence of Fine Management Combined With PDCA Cycle Method on Disinfection Qualified Rate and Performance Grade of Ophthalmic Precision Instruments
Authors: Zeng Fanli , Wang Xiuling , Gao Yan , Hu Ling 
Published: March 2022

ObjectiveThe aim of this study is to explore the influence of fine management combined with the plan-do-check-action (PDCA) cycle method on the management of ophthalmic precision instruments.MethodsThe ophthalmic precision instruments centralized in the disinfection supply room of our hospital were selected as the research objects and divided into groups A and B. Traditional instrument management method was adopted in group A, and fine management combined with the PDCA cycle method based on the group A was adopted in group B. The instrument management risk scores, the qualified rate of disinfection, instrument performance grade, and incidence of toxic anterior segment syndrome (TASS) of the two groups were compared.ResultsThe risk scores of instrument management and incidence of TASS in group B were lower than those in group A (p &lt; 0.05). The qualified rate of disinfection and instrument performance grades in group B were higher than those in group A (p &lt; 0.05).ConclusionFine management combined with the PDCA cycle method can improve the qualified rate of disinfection of ophthalmic precision instruments, optimize the performance of instruments, reduce the risk of instrument management, and reduce the incidence of TASS.
Newer long-acting insulin prescriptions for patients with type 2 diabetes: prevalence and practice variation in a retrospective cohort study
Authors: Dankers Marloes , Hek Karin , Nelissen-Vrancken Marjorie , Houweling Sebastiaan T , Mantel-Teeuwisse Aukje , van Dijk Liset 
Published: March 2022

BackgroundLittle is known about prescription patterns of expensive non-recommended newer long-acting insulins (glargine 300 U/mL and degludec) for patients with type 2 diabetes mellitus (T2DM).AimTo identify practice variation in, and practice- and patient-related characteristics associated with, the prescription of newer long-acting insulins to patients with T2DM in primary care.Design and settingA retrospective cohort study in Dutch general practices (Nivel Primary Care Database).MethodA first prescription for intermediate or long-acting insulins in 2018 was identified in patients aged ≥40 years using other T2DM drugs. Per practice, the median percentage and interquartile range (IQR) of patients with newer insulin prescriptions were calculated. Multilevel logistic regression models were constructed to calculate intraclass correlation coefficients (ICCs) and quantify the association of patient and practice characteristics with prescriptions for newer insulins (odds ratios [ORs] and 95% confidence intervals [CIs]).ResultsIn total, 7757 patients with prescriptions for intermediate or long-acting insulins from 282 general practices were identified. A median percentage of 21.2% (IQR 12.5–36.4%) of all patients prescribed intermediate or long-acting insulins per practice received a prescription for newer insulins. After multilevel modelling, the ICC decreased from 20% to 19%. Female sex (OR 0.77, 95% CI = 0.69 to 0.87), age ≥86 years compared with 40–55 years (OR 0.22, 95% CI = 0.15 to 0.34), prescriptions for metformin (OR 0.66, 95% CI = 0.53 to 0.82), sulfonylurea (OR 0.58, 95% CI = 0.51 to 0.66), or other newer T2DM drugs (OR 3.10, 95% CI = 2.63 to 3.66), and dispensing practices (OR 1.78, 95% CI = 1.03 to 3.10) were associated with the prescription of newer insulins.ConclusionThe inter-practice variation in the prescription of newer insulins is large and could only be partially explained by patient- and practice-related differences. This indicates substantial opportunities for improvement.
Non-antibiotic treatment of acute urinary tract infection in primary care: a qualitative study
Authors: Gbinigie Oghenekome A , Tonkin-Crine Sarah , Butler Christoper C , Heneghan Carl J , Boylan Anne-Marie 
Published: March 2022

BackgroundThe views of women with acute, uncomplicated urinary tract infection (auUTI) on the acceptability of non-antibiotic treatment options are poorly understood.AimTo establish women’s thoughts on and experience of non-antibiotic treatment for auUTIs.Design and settingQualitative interview study with primary care patients in Oxfordshire, UK, embedded within the Cranberry for Urinary Tract Infection (CUTI) feasibility trial.MethodOne-to-one, semi-structured interviews were conducted between August 2019 and January 2020 with some CUTI trial participants and some patients who were not part of the CUTI trial who had experienced at least one urinary tract infection (UTI) in the preceding 12 months in Oxfordshire, UK. Interviews were analysed using thematic analysis.ResultsIn total, 26 interviews were conducted and analysed. Women expected to receive an immediate antibiotic for their UTI but were aware of the potential harms of this approach. They were keen to find a non-antibiotic, ‘natural’ alternative that could effectively manage their symptoms. In certain situations (early illness, milder illness, and with no important upcoming engagements), women indicated they would be prepared to postpone antibiotic treatment by up to 3 days, especially if offered an interim non-antibiotic option with perceived therapeutic potential.ConclusionMany women with auUTIs are open to trying non-antibiotic treatments first in certain situations. There is scope for more dialogue between primary care clinicians and patients with auUTI around delaying antibiotic treatment and using non-antibiotic options initially, which could reduce antibiotic consumption for this common infection.