cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.30443972
title: Prevalence and risk factors of frailty among cardiac surgery patients: a systematic review and meta-analysis

description: Frailty is common among cardiac surgery patients and is associated with poor outcomes. Previous reviews have been limited by outdated searches, narrow surgical populations, or reliance on a single assessment tool. This study aimed to estimate the prevalence of frailty and identify associated risk factors in patients undergoing cardiac surgery. We searched MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science, and Scopus, from inception to March 1, 2025. Eligible studies reporting frailty prevalence in patients undergoing CABG, valvular surgery, or heart transplantation were included. Intervention studies, reviews, editorials, case series, and transcatheter procedures were excluded. Risk of bias was assessed by the Joanna Briggs Institute checklist. Random-effects meta-analysis provided pooled prevalence and risk factor estimates. Seventy-eight studies (<i>n</i> = 6,613,392) were included. The pooled frailty prevalence was 30.2% (95% CI: 28.3–32.0) with high heterogeneity (I<sup>2</sup> = 99.99%, <i>p</i> &lt; .001). Key sociodemographic associations were increasing age (SMD = 0.29 [0.18, 0.40]) and male sex (OR = 0.55 [0.46, 0.65]). Lower hemoglobin (SMD = −0.62 [−0.82, −0.42]) and albumin (SMD = −0.48 [−0.68, −0.28]) were significant laboratory correlates; NYHA class IV (OR = 6.29 [4.07, 9.71]) and higher EuroSCORE II (SMD = 0.52 [0.37, 0.68]) were strong clinical predictors. Comorbidities—including atrial fibrillation, liver, pulmonary, renal, neurological dysfunction, and diabetes—were also associated with frailty. Frailty impacts nearly one-third of cardiac surgery patients and is associated with several, partly modifiable factors. Preoperative screening using validated tools and focused management of modifiable risks could enhance perioperative outcomes. PROSPERO registration number: CRD420251015280
DOI: 10.6084/m9.figshare.30443972.v1
title: Prevalence and risk factors of frailty among cardiac surgery patients: a systematic review and meta-analysis

description: Frailty is common among cardiac surgery patients and is associated with poor outcomes. Previous reviews have been limited by outdated searches, narrow surgical populations, or reliance on a single assessment tool. This study aimed to estimate the prevalence of frailty and identify associated risk factors in patients undergoing cardiac surgery. We searched MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science, and Scopus, from inception to March 1, 2025. Eligible studies reporting frailty prevalence in patients undergoing CABG, valvular surgery, or heart transplantation were included. Intervention studies, reviews, editorials, case series, and transcatheter procedures were excluded. Risk of bias was assessed by the Joanna Briggs Institute checklist. Random-effects meta-analysis provided pooled prevalence and risk factor estimates. Seventy-eight studies (<i>n</i> = 6,613,392) were included. The pooled frailty prevalence was 30.2% (95% CI: 28.3–32.0) with high heterogeneity (I<sup>2</sup> = 99.99%, <i>p</i> &lt; .001). Key sociodemographic associations were increasing age (SMD = 0.29 [0.18, 0.40]) and male sex (OR = 0.55 [0.46, 0.65]). Lower hemoglobin (SMD = −0.62 [−0.82, −0.42]) and albumin (SMD = −0.48 [−0.68, −0.28]) were significant laboratory correlates; NYHA class IV (OR = 6.29 [4.07, 9.71]) and higher EuroSCORE II (SMD = 0.52 [0.37, 0.68]) were strong clinical predictors. Comorbidities—including atrial fibrillation, liver, pulmonary, renal, neurological dysfunction, and diabetes—were also associated with frailty. Frailty impacts nearly one-third of cardiac surgery patients and is associated with several, partly modifiable factors. Preoperative screening using validated tools and focused management of modifiable risks could enhance perioperative outcomes. PROSPERO registration number: CRD420251015280
DOI: 10.6084/m9.figshare.30729309
title: Preschool children’s eating behaviors and caregivers’ feeding practices in relation to children’s weight in China: a network analysis

description: This study aimed to characterize the interactions between preschool children’s eating behaviors and their caregivers’ feeding practices, and to compare these patterns across underweight, normal weight, and overweight/obesity groups using a network model. A cross-sectional survey (January–July 2021) included 3–6-year-old preschool children and their primary caregivers from seven cities in Shaanxi Province, China. Children’s eating behaviors and caregivers’ feeding practices were measured using the Chinese Preschoolers’ Eating Behavior Scale and the Chinese Preschoolers’ Caregivers’ Feeding Behavior Scale. Network centrality indices identified core and bridge behaviors, with stability assessed via case-dropping bootstrapping. The network had 14 nodes, 82 non-zero edges (90.11% of all possible edges), and all networks showed good stability (correlation stability coefficient &gt; 0.5). Among subgroups, the overweight/obese group had the highest mean edge weight (0.048), while the underweight group had the lowest non-zero edge proportion (45.05%). Across all samples, the strongest edge was between Feeding Responsibility and Content-Restricted Feeding (0.47), and the strongest cross-domain link was Emotional Eating-Weight Concerns (0.22), both stably confirmed by bootstrap. Feeding Responsibility had the highest strength (1.74) across groups, and Weight Concerns had the highest overall bridge strength (0.58), identifying it as a key connector. Edge weight distribution differed significantly between normal-weight and overweight/obese groups (<i>p</i> = 0.02). Network analysis identified Feeding Responsibility as core behavior and Weight Concerns as a critical cross-domain bridge, highlighting caregivers’ central role. These findings inform targeted interventions and nutritional strategies. Network analysis reveals that caregivers’ Feeding Responsibility (as core behavior) and Weight Concerns (as cross-domain bridge) are key in preschoolers’ feeding–eating network, emphasizing caregivers’ central role.Weight-specific differences in the feeding–eating network structure indicate that tailored interventions are necessary for preschoolers with different weight statuses.The study’s findings provide guidance for developing targeted nutritional strategies, with caregivers’ Feeding Responsibility and Weight Concern identified as priority intervention targets. Network analysis reveals that caregivers’ Feeding Responsibility (as core behavior) and Weight Concerns (as cross-domain bridge) are key in preschoolers’ feeding–eating network, emphasizing caregivers’ central role. Weight-specific differences in the feeding–eating network structure indicate that tailored interventions are necessary for preschoolers with different weight statuses. The study’s findings provide guidance for developing targeted nutritional strategies, with caregivers’ Feeding Responsibility and Weight Concern identified as priority intervention targets.
DOI: 10.6084/m9.figshare.30729309.v1
title: Preschool children’s eating behaviors and caregivers’ feeding practices in relation to children’s weight in China: a network analysis

description: This study aimed to characterize the interactions between preschool children’s eating behaviors and their caregivers’ feeding practices, and to compare these patterns across underweight, normal weight, and overweight/obesity groups using a network model. A cross-sectional survey (January–July 2021) included 3–6-year-old preschool children and their primary caregivers from seven cities in Shaanxi Province, China. Children’s eating behaviors and caregivers’ feeding practices were measured using the Chinese Preschoolers’ Eating Behavior Scale and the Chinese Preschoolers’ Caregivers’ Feeding Behavior Scale. Network centrality indices identified core and bridge behaviors, with stability assessed via case-dropping bootstrapping. The network had 14 nodes, 82 non-zero edges (90.11% of all possible edges), and all networks showed good stability (correlation stability coefficient &gt; 0.5). Among subgroups, the overweight/obese group had the highest mean edge weight (0.048), while the underweight group had the lowest non-zero edge proportion (45.05%). Across all samples, the strongest edge was between Feeding Responsibility and Content-Restricted Feeding (0.47), and the strongest cross-domain link was Emotional Eating-Weight Concerns (0.22), both stably confirmed by bootstrap. Feeding Responsibility had the highest strength (1.74) across groups, and Weight Concerns had the highest overall bridge strength (0.58), identifying it as a key connector. Edge weight distribution differed significantly between normal-weight and overweight/obese groups (<i>p</i> = 0.02). Network analysis identified Feeding Responsibility as core behavior and Weight Concerns as a critical cross-domain bridge, highlighting caregivers’ central role. These findings inform targeted interventions and nutritional strategies. Network analysis reveals that caregivers’ Feeding Responsibility (as core behavior) and Weight Concerns (as cross-domain bridge) are key in preschoolers’ feeding–eating network, emphasizing caregivers’ central role.Weight-specific differences in the feeding–eating network structure indicate that tailored interventions are necessary for preschoolers with different weight statuses.The study’s findings provide guidance for developing targeted nutritional strategies, with caregivers’ Feeding Responsibility and Weight Concern identified as priority intervention targets. Network analysis reveals that caregivers’ Feeding Responsibility (as core behavior) and Weight Concerns (as cross-domain bridge) are key in preschoolers’ feeding–eating network, emphasizing caregivers’ central role. Weight-specific differences in the feeding–eating network structure indicate that tailored interventions are necessary for preschoolers with different weight statuses. The study’s findings provide guidance for developing targeted nutritional strategies, with caregivers’ Feeding Responsibility and Weight Concern identified as priority intervention targets.
DOI: 10.6084/m9.figshare.29648778
title: Global, regional, and national time trends in prevalence of metabolic dysfunction associated steatotic liver disease among women of reproductive age: an age-period-cohort analysis for the global Burden of Disease 2021 study

description: This study aims to investigate the time trends in the prevalence of metabolic dysfunction associated steatotic liver disease (MASLD) among women of reproductive age (WRA) globally, regionally, and nationally from 1992 to 2021, and to explore associations with age, period, and birth cohort effects. MASLD prevalence estimates were sourced from the Global Burden of Disease (GBD) 2021 study. We used an age-period-cohort model to analyze cohort and period effects, overall annual percentage changes (net drifts), annual percentage change in each age group, and longitudinal age-specific rates. The global prevalence of MASLD among WRA nearly doubled from 165 million in 1992 to 307 million in 2021. Fifty-one countries reported over one million cases, with China, India, and Indonesia leading. The global net drift of MASLD prevalence among WRA was 0.70% per year, with a range from 0.38% in the low sociodemographic index (SDI) region to 1.29% in the high-SDI region. Of 204 countries, 195 exhibited increasing age-standardized prevalence rates (net drift ≥ 0.0% per year), with Italy, Brunei Darussalam, and Oman showing the largest increases. Both period and cohort effects displayed unfavorable trends across most countries, except for Cambodia. Increased MASLD prevalence was associated with rising summary exposure values for high BMI, low physical activity, and high fasting plasma glucose. MASLD in the WRA is an increasing health problem in all countries, and is accompanied by worsening period and cohort risks. These population-level trends warrant further investigation of their clinical implications for maternal health outcomes. Future research should focus on establishing evidence-based screening strategies and evaluating the clinical utility of interventions targeting liver health in WRA.
DOI: 10.6084/m9.figshare.29648778.v1
title: Global, regional, and national time trends in prevalence of metabolic dysfunction associated steatotic liver disease among women of reproductive age: an age-period-cohort analysis for the global Burden of Disease 2021 study

description: This study aims to investigate the time trends in the prevalence of metabolic dysfunction associated steatotic liver disease (MASLD) among women of reproductive age (WRA) globally, regionally, and nationally from 1992 to 2021, and to explore associations with age, period, and birth cohort effects. MASLD prevalence estimates were sourced from the Global Burden of Disease (GBD) 2021 study. We used an age-period-cohort model to analyze cohort and period effects, overall annual percentage changes (net drifts), annual percentage change in each age group, and longitudinal age-specific rates. The global prevalence of MASLD among WRA nearly doubled from 165 million in 1992 to 307 million in 2021. Fifty-one countries reported over one million cases, with China, India, and Indonesia leading. The global net drift of MASLD prevalence among WRA was 0.70% per year, with a range from 0.38% in the low sociodemographic index (SDI) region to 1.29% in the high-SDI region. Of 204 countries, 195 exhibited increasing age-standardized prevalence rates (net drift ≥ 0.0% per year), with Italy, Brunei Darussalam, and Oman showing the largest increases. Both period and cohort effects displayed unfavorable trends across most countries, except for Cambodia. Increased MASLD prevalence was associated with rising summary exposure values for high BMI, low physical activity, and high fasting plasma glucose. MASLD in the WRA is an increasing health problem in all countries, and is accompanied by worsening period and cohort risks. These population-level trends warrant further investigation of their clinical implications for maternal health outcomes. Future research should focus on establishing evidence-based screening strategies and evaluating the clinical utility of interventions targeting liver health in WRA.
DOI: 10.6084/m9.figshare.30231063
title: Withholding vs. continuing angiotensin-converting enzyme inhibitors or angiotensin receptor blockers before surgery: a systematic review and meta-analysis of randomized controlled trials

description: The optimal preoperative management of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) remains debated. This meta-analysis of randomized controlled trials (RCTs) assessed withholding vs. continuing ACEIs/ARBs on intraoperative hypotension and postoperative outcomes. PubMed, Web of Science, and China Biology Medicine were comprehensively searched to identify RCTs comparing preoperative withholding ACEIs/ARBs with a continuing therapy in adult patients. Two authors independently extracted and pooled data using a random-effects model. The primary outcome was the incidence of intraoperative hypotension. Secondary outcomes included duration of intraoperative hypotension, vasopressor use, postoperative hypotension and hypertension, major adverse cardiovascular events, acute kidney injury, duration of mechanical ventilation, length of stay in ICU and hospital, and 30-d mortality. Evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. Fourteen RCTs with 4063 patients were included. Withholding ACEIs/ARBs before noncardiac surgery was associated with a reduced incidence of intraoperative hypotension (36.4% vs. 48.4%; risk ratio = 0.73, 95% confidence interval = 0.60–0.88, <i>p</i> = 0.001, <i>I<sup>2</sup></i> = 63%; a very low certainty of evidence); it was associated with a shorter duration of intraoperative hypotension (mean difference = −5.41 min), reduced vasopressor use (37.5% vs. 51.2%), and increased postoperative hypertension (27.8% vs. 20.2%), without affecting other outcomes (low or very low certainty of evidence). While withholding ACEIs/ARBs may reduce intraoperative hypotension, the very low certainty of evidence underscores the need for future research to confirm clinical implications. PROSPERO (CRD42021253965).
DOI: 10.6084/m9.figshare.30231063.v1
title: Withholding vs. continuing angiotensin-converting enzyme inhibitors or angiotensin receptor blockers before surgery: a systematic review and meta-analysis of randomized controlled trials

description: The optimal preoperative management of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) remains debated. This meta-analysis of randomized controlled trials (RCTs) assessed withholding vs. continuing ACEIs/ARBs on intraoperative hypotension and postoperative outcomes. PubMed, Web of Science, and China Biology Medicine were comprehensively searched to identify RCTs comparing preoperative withholding ACEIs/ARBs with a continuing therapy in adult patients. Two authors independently extracted and pooled data using a random-effects model. The primary outcome was the incidence of intraoperative hypotension. Secondary outcomes included duration of intraoperative hypotension, vasopressor use, postoperative hypotension and hypertension, major adverse cardiovascular events, acute kidney injury, duration of mechanical ventilation, length of stay in ICU and hospital, and 30-d mortality. Evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. Fourteen RCTs with 4063 patients were included. Withholding ACEIs/ARBs before noncardiac surgery was associated with a reduced incidence of intraoperative hypotension (36.4% vs. 48.4%; risk ratio = 0.73, 95% confidence interval = 0.60–0.88, <i>p</i> = 0.001, <i>I<sup>2</sup></i> = 63%; a very low certainty of evidence); it was associated with a shorter duration of intraoperative hypotension (mean difference = −5.41 min), reduced vasopressor use (37.5% vs. 51.2%), and increased postoperative hypertension (27.8% vs. 20.2%), without affecting other outcomes (low or very low certainty of evidence). While withholding ACEIs/ARBs may reduce intraoperative hypotension, the very low certainty of evidence underscores the need for future research to confirm clinical implications. PROSPERO (CRD42021253965).
DOI: 10.6084/m9.figshare.28100414
title: Effect of curcumin on methotrexate-induced ovarian damage and follicle reserve in rats: the role of PARP-1 and P53

description: Methotrexate (MTX) is an agent used in the treatment of many neoplastic and non-neoplastic diseases and is known to cause oxidative damage in normal tissues. Curcumin (Cur) is a natural polyphenol compound with powerful antioxidant and antiapoptotic effects. In this study we investigate the effects of Cur on MTX-induced ovarian damage. Thirty-two young adult female Wistar albino rats were divided into four groups: (1) Control (<i>n</i> = 8): only vehicle group, (2) Cur (<i>n</i> = 8): Cur-only group (200 mg/kg/day), (3) MTX (<i>n</i> = 8): MTX-only group (0.35 mg/kg/day), (4) MTX+Cur (<i>n</i> = 8): The group was given MTX (0.35 mg/kg/day) and Cur (200 mg/kg/day) for 28 days. Then, SOD, CAT, MDA, AMH levels were measured using ELISA kits. Follicle count was performed on H&E stained slides. In addition, the expressions of P53 and PARP-1 were analysed by immunohistochemistry. MDA levels were seen to be higher in the MTX group than in the MTX+Cur group (<i>p</i> &lt; 0.05). Cur treatment lowered MDA levels and increased SOD and CAT levels (<i>p</i> &lt; 0.05 for all). In the MTX+Cur group, atretic follicle count decreased (<i>p</i> &lt; 0,05), however, primordial follicle count increased (<i>p</i> &lt; 0,01). Secondary follicle count and AMH levels were higher in MTX-treated groups (<i>p</i> &lt; 0,05 and <i>p</i> &lt; 0,01, respectively). Expressions of p53 and Poly [ADP-ribose] polymerase 1 (PARP-1) increased significantly in the MTX group compared to the other groups (<i>p</i> &lt; 0,05). Cur pretreatment prior to MTX administration may be an effective option in preserving the ovarian follicle pool by regulating P53 and PARP-1 expressions with its antioxidant effect. MTX has a negative effect on ovarian follicle reserve in ratsCurcumin, with its antioxidant activity, prevents MTX-induced follicle loss through the p53 and PARP-1 mediated pathway.In the MTX ovarian follicle reserve model in rats, AMH may be insufficient to reflect follicle reserve. MTX has a negative effect on ovarian follicle reserve in rats Curcumin, with its antioxidant activity, prevents MTX-induced follicle loss through the p53 and PARP-1 mediated pathway. In the MTX ovarian follicle reserve model in rats, AMH may be insufficient to reflect follicle reserve.
DOI: 10.6084/m9.figshare.28100414.v1
title: Effect of curcumin on methotrexate-induced ovarian damage and follicle reserve in rats: the role of PARP-1 and P53

description: Methotrexate (MTX) is an agent used in the treatment of many neoplastic and non-neoplastic diseases and is known to cause oxidative damage in normal tissues. Curcumin (Cur) is a natural polyphenol compound with powerful antioxidant and antiapoptotic effects. In this study we investigate the effects of Cur on MTX-induced ovarian damage. Thirty-two young adult female Wistar albino rats were divided into four groups: (1) Control (<i>n</i> = 8): only vehicle group, (2) Cur (<i>n</i> = 8): Cur-only group (200 mg/kg/day), (3) MTX (<i>n</i> = 8): MTX-only group (0.35 mg/kg/day), (4) MTX+Cur (<i>n</i> = 8): The group was given MTX (0.35 mg/kg/day) and Cur (200 mg/kg/day) for 28 days. Then, SOD, CAT, MDA, AMH levels were measured using ELISA kits. Follicle count was performed on H&E stained slides. In addition, the expressions of P53 and PARP-1 were analysed by immunohistochemistry. MDA levels were seen to be higher in the MTX group than in the MTX+Cur group (<i>p</i> &lt; 0.05). Cur treatment lowered MDA levels and increased SOD and CAT levels (<i>p</i> &lt; 0.05 for all). In the MTX+Cur group, atretic follicle count decreased (<i>p</i> &lt; 0,05), however, primordial follicle count increased (<i>p</i> &lt; 0,01). Secondary follicle count and AMH levels were higher in MTX-treated groups (<i>p</i> &lt; 0,05 and <i>p</i> &lt; 0,01, respectively). Expressions of p53 and Poly [ADP-ribose] polymerase 1 (PARP-1) increased significantly in the MTX group compared to the other groups (<i>p</i> &lt; 0,05). Cur pretreatment prior to MTX administration may be an effective option in preserving the ovarian follicle pool by regulating P53 and PARP-1 expressions with its antioxidant effect. MTX has a negative effect on ovarian follicle reserve in ratsCurcumin, with its antioxidant activity, prevents MTX-induced follicle loss through the p53 and PARP-1 mediated pathway.In the MTX ovarian follicle reserve model in rats, AMH may be insufficient to reflect follicle reserve. MTX has a negative effect on ovarian follicle reserve in rats Curcumin, with its antioxidant activity, prevents MTX-induced follicle loss through the p53 and PARP-1 mediated pathway. In the MTX ovarian follicle reserve model in rats, AMH may be insufficient to reflect follicle reserve.