Tag: pubmed

BMC Pregnancy Childbirth. 2024 Dec 23;24(1):852. doi: 10.1186/s12884-024-07081-y.

ABSTRACT

BACKGROUND: Preeclampsia is a severe pregnancy complication affecting 2-8% of pregnancies globally, contributing to substantial maternal and fetal morbidity and mortality. Vitamin D deficiency has been associated with an increased risk of preeclampsia, yet the efficacy of its supplementation during pregnancy in reducing preeclampsia incidence remains uncertain.

OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the impact of vitamin D supplementation on the incidence of preeclampsia and related maternal and neonatal outcomes.

METHOD: We systematically searched PubMed, Scopus, Cochrane Library, and Web of Science until August 2024 for randomized controlled trials (RCTs) examining the effects of vitamin D supplementation on preeclampsia. Eligible studies included pregnant women with varying doses of vitamin D supplementation compared to placebo or standard care. Primary outcomes were the incidence of pre-eclampsia and preterm labor; secondary outcomes included serum 25-hydroxyvitamin D levels, low birth weight, and APGAR scores. Data were synthesized using R statistical software, with effect measures reported as relative risk (RR) and mean difference (MD) with a 95% confidence interval (CI).

RESULTS: A total of 33 RCTs involving 10,613 participants were included. Vitamin D supplementation significantly reduced the risk of preeclampsia by 44.8% (RR = 0.55, 95% CI [0.43, 0.71], P < 0.0001) and preterm labor by 30% (RR = 0.70, 95% CI [0.51, 0.96], P = 0.0286). Subgroup analyses indicated that the benefits were more pronounced when the control group received a placebo rather than low-dose vitamin D. Serum 25-hydroxyvitamin D levels significantly increased in the supplementation group (MD = 32.42 nmol/L, 95% CI [20.33, 44.50], P < 0.0001). However, no significant differences were observed in the incidence of low birth weight (RR = 0.65, 95% CI [0.42, 1.02], P = 0.057) or Apgar scores at 5 min (MD = 0.20, 95% CI [-0.01, 0.40], P = 0.057).

CONCLUSION: Vitamin D supplementation during pregnancy significantly reduces the risk of preeclampsia and preterm labor, though its impact on neonatal outcomes remains unclear. These findings underscore the potential value of vitamin D supplementation in prenatal care for improving maternal outcomes. Further research is needed to clarify its effects on neonatal health.

PMID:39716171 | DOI:10.1186/s12884-024-07081-y

J Neuroeng Rehabil. 2024 Dec 23;21(1):227. doi: 10.1186/s12984-024-01507-6.

ABSTRACT

OBJECTIVE: Cognitive-motor dual-tasking training (CMDT) might improve limb function and motor performance in stroke patients. However, is there enough evidence to prove that it is more effective compared with conventional physical single-task training? This meta-analysis and Trial Sequential Analysis of randomized clinical trials (RCTs) aimed to evaluate the effectiveness of CMDT on balance and gait for treating hemiplegic stroke patients.

METHODS: The databases were searched in PubMed, Web of Science, Ovid Database and The Cochrane Library, SinoMed database, Chinese National Knowledge Infrastructure (CNKI), Wan Fang database, and VIP database up to December 8, 2023. The Cochrane-recommended risk of bias (RoB) 2.0 tool was employed to assess risk of bias in trials. The statistical analysis was employed using R version 4.3.2. In addition, subgroup analyses and meta-regression were performed to explore the possible sources of heterogeneity. The evidence for each outcome was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. The Copenhagen Trial Unit’s Trial Sequential Analysis (version 0.9.5.10 Beta) was used for sequential analysis.

RESULTS: Seventeen randomized clinical trials (RCTs) (n = 751 patients) were included. The results demonstrated that cognitive-motor dual-task training (CMDT) might be beneficial on stroke patients on Berg Balance Scale (BBS) (MD = 4.26, 95% CI 1.82, 6.69, p < 0.0001) (low-quality evidence). However, CMDT might not affect Time Up and Go test (TUG) (MD = -1.28, 95% CI -3.63, 1.06, p = 0.284); and single-task walking speed (MD = 1.35, 95% CI -1.56, 4.27, p = 0.413) in stroke patients (low-quality evidence). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) results indicated that all findings were very low to low certainty. Trial Sequential Analyses demonstrated larger sample sizes are required for confirming our findings.

CONCLUSION: Cognitive-motor dual-task training (CMDT) compared with conventional physical single-task training might be an effective intervention for improving static balance function in stroke patients (low-quality evidence), which should be interpreted cautiously due to heterogeneity and potential biases. Nevertheless, further research is required to support the abovementioned findings. Trial Registration This protocol was registered in PROSPERO (CRD42023490530).

PMID:39716165 | DOI:10.1186/s12984-024-01507-6

BMC Psychiatry. 2024 Dec 23;24(1):940. doi: 10.1186/s12888-024-06412-9.

ABSTRACT

BACKGROUND: New mothers frequently encounter postpartum depression, anxiety, and stress symptoms, which pose challenges in diagnosis and treatment owing to their intricate interplay. This study employs network analysis to explore the interconnections between these symptoms and identify potential intervention points.

METHODS: The study was carried out from December 2023 to June 2024 at the postpartum clinics of three representative tertiary hospitals in Nantong City. The participants were mothers undergoing their 42-day postpartum check-up. Participants completed the Edinburgh Postnatal Depression Scale (EPDS), the Depression, Anxiety, and Stress Scales (DASS-21), and the Maternal postpartum stress scale (MPSS). The R language was used to construct the network. Network analysis was also carried out to explore the network structure, centrality indices (strength, closeness, betweenness, and expected influence), and the stability of the network.

RESULTS: A total of 625 women were included. The resulting network indicates a close interconnection between communities associated with depression, anxiety, and stress. As assessed on the centrality index, “I have felt sad or miserable” (EPDS-8), “Baby’s irregular patterns of daily sleep” (MPSS-9), “lack of time for myself” (MPSS-19), “I have been so unhappy that I have been crying” (EPDS-4), and “Physical appearance after childbirth” (MPSS-20) are the five most important nodes of these three network structures. High network stability (> 0.7).

CONCLUSION: Postpartum-specific stress symptoms play a significant role in the network of postpartum depression, anxiety, and stress, and identifying the central symptoms of depression, anxiety, and stress can provide a scientific basis for the development of precise interventions.

CLINICAL TRIAL NUMBER: Not Applicable.

PMID:39716162 | DOI:10.1186/s12888-024-06412-9

BMC Med Inform Decis Mak. 2024 Dec 23;24(1):400. doi: 10.1186/s12911-024-02826-3.

ABSTRACT

BACKGROUND: Hypoglycaemia is one of the most common complications during the neonatal period. Recurrent hypoglycaemia episodes can result in neurodevelopmental deficits and even sudden death. Available evidence indicates that healthcare professionals ought to promptly assess the risk of hypoglycaemia in newborns immediately following birth and formulate the most suitable preventive strategies. Consequently, this study was designed to develop a clinical nursing decision support system for neonatal hypoglycaemia prevention based on the prediction model for neonatal hypoglycaemia risk that was developed in a previous study, and to evaluate its efficacy.

METHODS: Nursing process as the theoretical framework, based on evidence-based nursing, standardized nursing language, and clinical decision support technology, the neonatal hypoglycaemia prevention nursing decision support system was developed.This system was implemented in the neonatology department of a tertiary grade A general hospital from September 1st to 30th, 2023.The application efficacy of the system was assessed and compared through the examination of the incidence of neonatal hypoglycemia, adverse outcomes associated with neonatal hypoglycemia, and the experiences of nurses following the implementation of the system.

RESULTS: The incidence of neonatal hypoglycaemia decreased after the system was implemented, and the difference was statistically significant (X² = 4.522, P = 0.033). None of the neonates experienced adverse outcomes during hospitalization. The rate of hypoglycaemia risk assessment in neonates after system implementation was 92.16%. The total Clinical Nursing Information System Effectiveness Evaluation Scale score was 104.36 ± 1.96.

CONCLUSION: The neonatal hypoglycaemia prevention nursing decision support system realizes neonatal hypoglycaemia risk assessment, intelligent decision-making, and effect evaluation, effectively diminishes the incidence of neonatal hypoglycaemia, and enhances the standardization of neonatal hypoglycaemia management.

PMID:39716159 | DOI:10.1186/s12911-024-02826-3

BMC Public Health. 2024 Dec 23;24(1):3563. doi: 10.1186/s12889-024-20992-x.

ABSTRACT

BACKGROUND: Digital leadership might be an innovative approach to decreasing the elevated rates of anxiety and depression symptoms among medical professionals, while also enhancing their psychological well-being. This emerging pathway may offer promising strategies to support the mental health of medical professionals. This study seeks to investigate the association among digital leadership, organizational identity, family-work conflict, and anxiety and depression symptoms, and further to uncover the underlying moderating mechanisms interplay.

METHODS: A cross-sectional online survey with 657 valid data were collected from four tertiary hospitals in Harbin, Heilongjiang Province, China, with a response rate of 69.3%. The statistical analysis was conducted employing IBM SPSS Statistics 22.0. Hierarchical regression analysis was performed to scrutinize the pertinent factors associated with anxiety and depression symptoms among medical professionals, while also evaluating the moderating influence of organizational identity and family-work conflict on the nexus among those.

RESULTS: The prevalence of anxiety and depression symptoms among medical professionals was 50.1%. Anxiety and depression symptoms were negatively correlated with digital leadership (r= -0.278, p < 0.01) and organizational identity (r = – 0.318, p < 0.01), and positively correlated with family-work conflict (r = 0.445, p < 0.01). Organizational identity (β = – 0.938, p < 0.05) and family-work conflict (β = 0.698, p < 0.05) moderate the relationship between digital leadership and anxiety and depression symptoms; The results of the simple slope analysis indicated that high organizational identity and low family-work conflict strengthened the effect of digital leadership on anxiety and depression symptoms among Chinese medical professionals.

CONCLUSIONS: The prevalence of anxiety and depression symptoms among medical professionals was noted to be high. This study posits that strengthening digital leadership could apparently improve anxiety and depression symptoms among medical professionals. Moreover, it highlights the moderating role of organizational identity and family-work conflict in the relationship between digital leadership and anxiety and depression symptoms. These discoveries underscore the significance of implementing support and interventions to enhance the mental well-being of medical professionals, encompassing the cultivation of organizational identity, reduction of family-work conflict, and acknowledgment of the potential role of digital leadership in addressing mental health challenges.

PMID:39716125 | DOI:10.1186/s12889-024-20992-x

BMC Pediatr. 2024 Dec 23;24(1):833. doi: 10.1186/s12887-024-05320-x.

ABSTRACT

BACKGROUND AND OBJECTIVE: Microsurgical resection of tumor is an important treatment for children with fourth ventricular tumors. There is a lack of data describing risk factors for postoperative extubation failure (EF) in these children. We aimed to identify risk factors for EF in children with fourth ventricular tumors and to determine the association between EF and clinical outcomes.

METHODS: A retrospective study review of children after fourth ventricular tumors surgery who had an extubation attempt between January 2020 to December 2023. Extubation failure was defined as re-intubation within 7 days of extubation. Multivariate logistic regression analysis was performed to explore the risk factors for EF. Bivariate statistical analysis was performed to determine associations between EF and clinical outcomes. Only the first extubation attempt was included in the analysis.

RESULTS: We included 103 children, of whom 10 (9.7%) experienced EF. In the logistic regression analysis, a weak/absent cough reflex was independently associated with EF (p < 0.001). Compared to those with a fair/ strong cough, patients with a weak/absent cough had a odds ratio (OR) of 41.25 for EF (95% CI,8.01-212.37; p < 0.001).Glasgow Coma Score(GCS), the obvious adhesion between the tumor and the fourth ventricle floor, and pulmonary variables were not associated with EF. Children who failed extubation had longer durations of mechanical ventilation [13 days (IQR 6.8-22.8) vs. 1 days (IQR 0.5-3), p < 0.001]; longer PICU lengths of stay [16.5 days (IQR 9.4-27.5) vs. 2 days (IQR1.5-4.3), p < 0.001] and longer hospital lengths of stay [27 days (IQR 21-31.8) vs. 20 days (IQR16-29), p = 0.05] than successfully extubated children.

CONCLUSIONS: Children with weak/absent cough reflex after surgery are at increased risk for extubation failure. Extubation failure is associated with significant adverse outcomes in our setting.

PMID:39716124 | DOI:10.1186/s12887-024-05320-x

BMC Oral Health. 2024 Dec 23;24(1):1542. doi: 10.1186/s12903-024-05347-7.

ABSTRACT

BACKGROUND: Lithium disilicate occlusal veneers are popular for minimally invasive posterior teeth restoration. The aim of this study was to compare the fatigue resistance and crack pattern of lithium disilicate occlusal veneers fabricated using pressing and milling techniques with varying thicknesses.

METHODS: Sixty lithium disilicate discs, representing occlusal veneers, were divided into four groups (n = 15) based on processing technique (IPS e.max Press or IPS e.max CAD) and thickness (0.5 or 0.8 mm). A step-stress fatigue test was applied with axial loading, consisting of 10,000 cycles/step with a step size of 50 N until failure. Fractographic analysis was performed using SEM. Statistical analysis was performed using the Kaplan-Meier test, Mantel-Cox test, and Weibull analysis.

RESULTS: Both processing techniques resulted in similar fatigue resistances at 0.5 mm and 0.8 mm thicknesses. However, the 0.8 mm lithium disilicate restorations showed a significantly higher survival rate than the 0.5 mm lithium disilicate restorations (log-rank tests, χ² = 58.6; df = 3; P < 0.001). Fractographic analysis revealed radial cracks originating from defects on the ceramic surface at the cementing interface, extending towards the occlusal surface.

CONCLUSIONS: At 0.5 mm or 0.8 mm material thickness, the processing technique did not affect the fatigue resistance or crack patterns of the lithium disilicate occlusal veneers. However, the lithium disilicate with a thickness of 0.8 mm exhibited a superior survival probability compared to that with a thickness of 0.5 mm.

PMID:39716117 | DOI:10.1186/s12903-024-05347-7

BMC Pregnancy Childbirth. 2024 Dec 23;24(1):848. doi: 10.1186/s12884-024-07077-8.

ABSTRACT

BACKGROUND: Hyperemesis gravidarum (HG), excessive vomiting in pregnancy, occurs in 0.3-10.8% of pregnancies and is associated with maternal and fetal morbidity. Despite the existence of several off-label treatment options that have shown clinical effectiveness in managing HG symptoms, the variability in treatment response highlights the need for more effective therapies. Our study aims to identify novel therapeutic targets that could lead to the development of additional, more effective treatment options.

METHODS: A two-sample Mendelian randomization (MR) analysis was performed to estimate the causal effects of blood-druggable genes on HG. Summary statistics for HG were obtained from the FinnGen study and UK Biobank. Cis-expression quantitative trait loci (cis-eQTL) for blood druggable genes were obtained from the eQTLGen Consortium and used as genetic instrumental variables. Another MR method, summary level mendelian randomization (SMR), was used to further confirm our results. We also used eQTL data of other vomiting-related tissues, brain regions, and esophagus, to validate our MR results. Finally, the potential side effects of the druggable genes for HG treatment were assessed using a phenome-wide MR.

RESULTS: Overall, 2499 unique druggable genes were gathered. Two blood drug targets (OVGP1 and LGALS1) showed significant MR results in two independent datasets. No significant heterogeneity of instrumental variables or pleiotropy was detected. In addition, SMR analysis further confirmed the significance of these two prior druggable genes in the brain and esophagus tissues. Further phenome-wide MR analysis revealed no association between genetic proxies of OVGP1, and LGALS1 has been detected in increasing the risk of adverse pregnancy outcomes and other common diseases.

CONCLUSIONS: This study provides genetic evidence that targeting two druggable genes for HG has potential therapeutic advantages. This information is of considerable value in guiding and prioritizing the development of more effective therapies for HG.

PMID:39716115 | DOI:10.1186/s12884-024-07077-8

BMC Nephrol. 2024 Dec 23;25(1):471. doi: 10.1186/s12882-024-03872-9.

ABSTRACT

BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is a known complication after coronary angiography (CAG) or percutaneous coronary intervention (PCI). Clinical evidence suggests that trimetazidine (TMZ), an anti-ischemic drug, may prevent CI-AKI. We aimed to evaluate the role of trimetazidine in preventing CI-AKI in patients with pre-existing renal dysfunction undergoing CAG or PCI.

METHODS: We searched PubMed, Cochrane Library, EBSCOhost, Web of Science, and Google Scholar databases from January 2004 to January 2024. We reviewed RCTs involving participants aged ≥ 18 years with pre-existing renal insufficiency who underwent CAG or PCI. Outcomes should include the incidence of CI-AKI, adverse events, and changes in serum creatinine (Scr) levels at different time intervals. Two reviewers independently extracted the data, evaluated the quality and relevance of the studies, and graded the strength of evidence for each study through consensus.

RESULTS: Nine RCTs met the inclusion criteria and assessed the role of TMZ in patients with renal dysfunction who underwent CAG or PCI. All RCTs showed a significant decrease in the incidence of CI-AKI in the TMZ group compared to the control group (RR 0.36, 95% CI, [0.25, 0.52] P < 0.001). Changes in Scr at 24 h (SMD -0.33, 95% CI, [-0.56, -0.10], P = 0.01), at 48 h (SMD -0.27, 95% CI, [-0.46, -0.09], P = 0.01), and 72 h (SMD -0.32, 95% CI, [-0.56, -0.07], P = 0.01) were statistically significant in the TMZ group compared to the control group. However, the changes in Scr beyond 72 h following CAG or PCI were statistically insignificant in the TMZ group when compared to the control group (SMD -0.22, 95% CI, [-0.52, 0.09], P = 0.16). The incidence of adverse effects was lower in the TMZ group than in the control group, and the difference was statistically significant (RR 0.51, 95% CI, [0.29, 0.90]; P = 0.02).

CONCLUSION: The addition of TMZ to standard hydration protocols may offer a promising strategy for lowering the incidence of CI-AKI, adverse events, and postoperative SCr levels in patients with renal insufficiency within 72 h after CAG or PCI. However, large-scale RCTs are necessary to definitively establish the efficacy and safety of TMZ in patients with renal insufficiency after CAG or PCI.

PMID:39716106 | DOI:10.1186/s12882-024-03872-9

BMC Cancer. 2024 Dec 24;24(1):1573. doi: 10.1186/s12885-024-13302-6.

ABSTRACT

BACKGROUND: Evidence of the association between sleep duration, depressive symptoms, and mortality in cancer survivors is limited.

METHODS: 2,111 participants from the National Health and Nutrition Examination Surveys were involved and linked to a mortality database up to 31 December 2019. Sleep duration was self-reported at baseline. Depressive symptom was assessed using the Patient Health Questionnaire (PHQ-9) and a total score of ≥ 10 is considered clinically relevant depressive symptoms. Cox proportional hazards regression model was the main statistical models.

RESULTS: A 2% increase in all-cause mortality was found for each 1-point increase in depressive symptoms score (hazard ratio [HR], 1.02; 95% confidence interval [CI], 1.00-1.03). Compared with those patients who slept 7 h, positive associations of < 6 h (HR, 1.79; 95% CI, 1.29-2.50), 8 h (HR, 1.46; 95% CI, 1.15-1.85), and > 8 h (HR, 1.49; 95% CI, 1.09-2.05) durations with all-cause mortality were observed. In the joint analysis, cancer survivors with depressive symptoms had a higher risk of all-cause mortality when sleeping < 6 h (HR, 1.69; 95% CI, 1.09-2.62) or ≥ 8 h (HR, 1.55; 95% CI, 1.02-2.35).

LIMITATIONS: Dynamics of sleep and depression data were not available.

CONCLUSIONS: Long (≥ 8 h) and short (< 6 h) sleep duration was both associated with increased risks of all-cause deaths after adjusting for depressive symptoms scores. We also observed a joint effect of sleep duration and depressive symptoms. The findings may provide evidence to guide optimal sleep duration for prolonged cancer survival.

PMID:39716102 | DOI:10.1186/s12885-024-13302-6