Background:A systematic evaluation and meta-analysis of randomized controlled trials(RCTs)was conducted to assess the impact of immunonutritional interventions on sarcopenia in oncology patients.Methods:A computerized...Background:A systematic evaluation and meta-analysis of randomized controlled trials(RCTs)was conducted to assess the impact of immunonutritional interventions on sarcopenia in oncology patients.Methods:A computerized search of the PubMed,Embase,the Cochrane Library,and Web of Science databases was performed.The studies included in the final analyses encompassed 7 high-quality RCTs,involving 432 tumor patients.The intervention group received immunonutritional supplements enriched with omega-3 fatty acids,arginine,glutamine,and other nutrients.The control group received a standard diet or a placebo.Primary outcome indicators included muscle mass,body weight,body mass index(BMI),inflammatory markers[e.g.,C-reactive protein(CRP),interleukin(IL)-6],and patient prognosis.The study followed the PRISMA 2020 guidelines.Results:Meta-analyses showed that immunonutritional interventions reduced IL-6 levels compared with the control group(mean=-5.85,95%CI:-10.88 to -0.82,P=0.02).No significant differences were observed in the body weight(mean=-1.50,95%CI:-6.24 to 3.24,I^(2)=0,P=0.54),BMI(mean=-0.38,95%CI:-1.84 to 1.09,I^(2)=0,P=0.61),handgrip strength(mean=1.97,95%CI:-2.94 to 6.88,I^(2)=0,P=0.43),or fat tissue index(mean=0.70,95%CI:-0.56 to 1.97,I^(2)=0,P=0.27).CRP levels showed a nonsignificant downward trend in the intervention group(mean=-4.13,95%CI:-13.63 to 5.38,I^(2)=66%,P=0.39),with high heterogeneity potentially attributable to differences in trial design,patients’baseline status,and intervention methods.Risk of bias assessment confirmed the high quality of the included studies.Conclusions:Immunonutritional interventions may modulate inflammatory responses in oncology patients,particularly those at higher nutritional risk,but their effect on enhancing muscle mass was not statistically confirmed.Impacts on body weight and BMI remain ambiguous,potentially influenced by factors such as the specific intervention administered,its duration,the concentrations of the different components,and the patients’baseline status.This study provides preliminary support for immunonutrition in managing sarcopenia in oncology patients;however,additional high-quality RCTs with larger sample sizes and standardized protocols are needed to further substantiate the efficacy and safety of the interventions,thereby providing a more robust evidence-based foundation for clinical practice.展开更多
Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strate...Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strategies for clinical nursing.Methods:Eighty patients with hypertensive intracerebral hemorrhage admitted to our hospital from January 2023 to June 2025 were selected and randomly divided into an observation group(n=40,receiving systematic stepwise rehabilitation nursing)and a control group(n=40,receiving conventional nursing).The intervention effects were analyzed by comparing changes in the National Institutes of Health Stroke Scale(NIHSS)scores for neurological recovery,Short Form 36 Health Survey(SF-36)scores for quality of life,Exercise of Self-Care Agency Scale(ESCA)scores for self-management ability,compliance,and the Mishel Uncertainty in Illness Scale(MUIS)scores between the two groups.Results:All scores in the observation group were significantly better than those in the control group after the intervention(p<0.05).Specifically,the NIHSS scores decreased more significantly,the total SF-36 scores increased,the ESCA scores increased significantly,while the MUIS scores decreased significantly,and compliance improved markedly,indicating a reduction in disease uncertainty among patients.Conclusion:Systematic stepwise rehabilitation nursing intervention can significantly improve neurological recovery,quality of life,self-management ability,and compliance in patients with hypertensive intracerebral hemorrhage,while effectively reducing disease uncertainty.It is worthy of clinical promotion and application.展开更多
Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interv...Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interventions have been shown to help students develop healthy stress coping strategies.The purpose of this systematic review and meta-analysis was to examine the diverse array of coping interventions and what characteristics of coping interventions were most effective at decreasing stress among healthcare students.Methods:Any intervention designed to address coping for academic stress was included among medical,dental,nursing,physician assistant,allied health,veterinary,psychology,etc.students.A comprehensive literature search was completed to include multiple databases,Ancestry,and hand-searching from EBSCO and Google Scholar articles.A final total of 17 studies were included.Standardized mean difference effect sizes(ES)were synthesized across studies using a random-effects model in the Comprehensive Meta-Analysis Software for changes in coping levels in healthcare students.Moderator analyses were performed to explore the study,intervention,and participants’characteristics.The risk of bias was assessed by RoB2 and ROBINS-I.Results:Coping interventions significantly reduced stress outcomes among healthcare students(d=0.74;95%CI[0.48–1.01],95%PI[−0.41–1.90],p<0.001,Q=228.49,I^(2)=93.0%,T=0.52,T^(2)=0.28,p<0.001).Moderator analysis showed that interventions with stress education,established professional guidance,and fewer hours led to better stress management outcomes.Conclusions:This study demonstrates that coping interventions produce an overall moderate-to-large effect on stress reduction.Future research investigating coping interventions on academic and long-term outcomes would be beneficial.展开更多
BACKGROUND Urolithiasisposes challenges in patients with chronic kidney disease(CKD),necessitating careful consideration of surgical interventions due to potential complications.AIM To assess the safety,feasibility,an...BACKGROUND Urolithiasisposes challenges in patients with chronic kidney disease(CKD),necessitating careful consideration of surgical interventions due to potential complications.AIM To assess the safety,feasibility,and efficacy of surgical interventions for urolithiasis in CKD patients.METHODS Systematic review adhering to PRISMA guidelines.Comprehensive searches of PubMed,Scopus,Cochrane Library,Web of Science,and Embase were conducted for studies published from January 2014 to June 2024.Studies involving adult patients(≥18 years)with CKD undergoing surgical interventions for urolithiasis,including randomized controlled trials,cohort studies,case-control studies,and observational studies.Studies involving pediatric patients,those not specifically addressing CKD patients,review articles,commentaries,and editorials.Despite an extensive search,only six studies met the strict inclusion criteria,reflecting the limited available data on this topic.This limitation has been acknowledged and discussed.RESULTS A total of 6 studies met the inclusion criteria,encompassing a diverse range of surgical interventions such as percutaneous nephrolithotomy(PCNL),ureteroscopy(URS),and extracorporeal shock wave lithotripsy(ESWL).Perioperative and postoperative complications varied across studies,with bleeding,infection,and acute kidney injury being the most common.The risk of complications was higher in patients with advanced CKD.Technical success rates were generally high,but feasibility was influenced by patientspecific factors such as CKD stage and comorbidities.Modifications to standard surgical techniques were often necessary.Stone-free rates and recurrence rates varied,with PCNL generally achieving higher stone-free rates compared to URS and ESWL.Long-term outcomes on renal function were inconsistent,highlighting the need for individualized treatment plans.CONCLUSION Surgical interventions for urolithiasis in CKD patients are associated with significant risks but can be effective in achieving stone clearance and symptom relief.The safety,feasibility,and efficacy of these interventions depend on patient-specific factors,necessitating a tailored approach.Further high-quality studies are needed to develop standardized guidelines and improve clinical outcomes in this complex patient population.展开更多
Objective:To assess the method of empathy intervention in nursing students in relation to the three dimensions of empathy:cognitive,affective,and behavioral.Methods:A systematic literature review was conducted followi...Objective:To assess the method of empathy intervention in nursing students in relation to the three dimensions of empathy:cognitive,affective,and behavioral.Methods:A systematic literature review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)2020 guideline.A search for articles in two databases(ScienceDirect and Taylor&Francis)revealed 99 articles.One author independently assessed articles for inclusion,resulting in 10 articles that met the inclusion criteria.Results:Based on a review of ten extracted journal articles,nine interventions showed increases in empathy,while one intervention did not show such outcomes.Four studies(the simulation-based empathic communication training intervention,the situated teaching program,high-fidelity simulation[HFS]training,and the structured empathy educational model[EEM])discussed the impact of interventions on the empathy dimension,while the remaining five only explained the impact of the intervention on empathy in general.Conclusions:The result of this study highlight the need for future research to design empathy interventions for nursing students that effectively target both the affective and behavioral dimensions of empathy.展开更多
BACKGROUND Postpartum depression(PPD)is a prevalent and debilitating psychiatric disorder affecting maternal mental health,infant development,and family well-being.Despite increasing global awareness,significant dispa...BACKGROUND Postpartum depression(PPD)is a prevalent and debilitating psychiatric disorder affecting maternal mental health,infant development,and family well-being.Despite increasing global awareness,significant disparities remain in screening,diagnosis,and treatment,particularly in low-resource and culturally diverse settings.The complex interplay of biological and psychosocial determinants complicates conventional intervention models.Integrating epidemiological patterns,pathophysiological mechanisms,and sociocultural factors will inform more effective and equitable strategies for PPD screening,prevention,and treatment.METHODS A narrative review was conducted following PRISMA 2020 guidelines.Peer-reviewed studies published from January 2010 to May 2025 were systematically searched in PubMed,Web of Science,EMBASE,and PsycINFO.Inclusion criteria comprised studies addressing PPD epidemiology,risk stratification,biological mechanisms,and intervention strategies.After screening and full-text review,84 studies were included.Study designs primarily involved cohort studies,randomized controlled trials,and meta-analyses.Extracted data were categorized thematically and assessed for methodological quality and generalizability.RESULTS PPD arises from multifactorial interactions involving hormonal dysregulation,neurochemical changes,psychosocial stressors,and cultural influences.Primary risk factors include personal or family history of depression,antenatal anxiety,low maternal self-efficacy,and inadequate social support.Evidence-based interventions encompass Edinburgh Postnatal Depression Scale-based screening,cognitive behavioral therapy,interpersonal psychotherapy,psychoeducation,and pharmacological treatments such as brexanolone and zuranolone.Culturally adapted,community-integrated models—including stepped-care approaches and task-shifting—improve feasibility and scalability,particularly in underserved populations.Emerging evidence highlights inflammatory biomarkers(e.g.,interleukin-6 and C-reactive protein),AI-assisted screening tools,and family-inclusive strategies as promising for enhanced detection and outcomes.CONCLUSION Effective PPD management requires integrative,culturally sensitive approaches,prioritizing scalable,personalized non-pharmacological interventions to reduce disparities and enhance maternal mental health equity across diverse populations.展开更多
Purpose:This study aimed to provide comparative evidence on the effectiveness of various lifestyle interventions on body composition management for preschool and school-aged children.Methods:PubMed(MEDLINE),Embase,CIN...Purpose:This study aimed to provide comparative evidence on the effectiveness of various lifestyle interventions on body composition management for preschool and school-aged children.Methods:PubMed(MEDLINE),Embase,CINAHL,and Web of Science were systematically searched for this network meta-analysis.Randomized controlled studies(RCTs)that included children aged 4-12 years with no physical or mental conditions;performed at least 1 type of lifestyle intervention;reported change in body mass index(BMI),BMI z-score,or body fat percentage(BFP);and were published between January2010 and August 2023 were included.Results:The final analysis included 91 RCTs with aggregate data for 58,649 children.All interventions were categorized into single-arm approaches(physical activity,diet,and behavioral and informational support)and combined arms approaches(bicomponent and multicomponent treatment).Multicomponent treatment showed significant effectiveness on the reduction of BMI(mean deviation(MD)-0.49,95%confidence interval(95%CI):-0.88 to-0.12),BMI z-score(MD=-0.11,95%CI:-0.18 to-0.04),and BFP(MD=-1.69,95%CI:-2.97 to-0.42)compared to the usual care condition.Bicomponent treatment also significantly reduced BMI(MD=-0.28,95%CI:-0.54 to-0.04)and BMI z-score(MD=-0.07,95%CI:-0.12 to-0.02)compared to usual care.Conclusion:Interventions targeting multiple lifestyle components achieved greater reductions in children's BMI and BFP.Among single-component approaches,physical activity engagement emerged as the most effective.These findings should guide practitioners in recommending comprehensive lifestyle modifications for children.Moreover,children with higher initial BMI and body fat levels tend to exhibit more positive responses to lifestyle interventions aimed at managing obesity.展开更多
Background:Foreign Language Anxiety(FLA)represents a substantial affective barrier that undermines cognitive performance,motivation,and retention in language learners.Emerging evidence highlights mindfulness-based int...Background:Foreign Language Anxiety(FLA)represents a substantial affective barrier that undermines cognitive performance,motivation,and retention in language learners.Emerging evidence highlights mindfulness-based interventions as promising strategies for enhancing emotional regulation and reducing anxiety across educational contexts.This review synthesizes current research on mindfulness as a psychological intervention,aims to evaluate its efficacy in alleviating FLA,and discusses its broader implications for health-focused educational policy and practice.Methods:Following PRISMA guidelines,we systematically reviewed studies examining the relationships between mindfulness and FLA.Our search of four major databases(November 2023)initially identified 346 articles using terms like“mindfulness AND language anxiety.”After screening,14 studies met our criteria:(1)empirical research in English on mindfulness-FLA relationships;(2)no publication date restrictions.Two independent reviewers selected studies,excluding two due to methodological limitations.We conducted a narrative synthesis given the study heterogeneity(9 correlational and 5 intervention studies).Results:9 non-intervention studies demonstrated that mindfulness is negatively associated with FLA,with 3 studies highlighting the mediating roles of self-efficacy and resilience.5 intervention studies reported inconsistent results regarding the efficacy of mindfulness-based interventions in reducing FLA.Conclusions:The findings suggest that while mindfulness holds promise as a tool to address FLA,its mechanisms and effectiveness require further investigation.This study underscores the need for rigorous research,including Randomized Controlled Trials(RCTs),to inform evidence-based integration of mindfulness into foreign language curricula.For educational policymakers and practitioners,these insights highlight the importance of adopting mindfulness interventions cautiously,ensuring they are tailored to students’needs and supported by evidence.展开更多
BACKGROUND Glycated hemoglobin(HbA1c)is a well-established biomarker for diagnosing and managing diabetes.However,its prognostic significance in patients without diagnosed diabetes undergoing percutaneous coronary int...BACKGROUND Glycated hemoglobin(HbA1c)is a well-established biomarker for diagnosing and managing diabetes.However,its prognostic significance in patients without diagnosed diabetes undergoing percutaneous coronary intervention(PCI)remains uncertain.This systematic review and meta-analysis evaluates the association between elevated HbA1c levels in the prediabetic range(≥5.7%)and adverse cardiovascular outcomes in this population.AIM To investigate the association between elevated HbA1c levels in the prediabetic range and adverse outcomes in patients without diagnosed diabetes undergoing PCI.METHODS We systematically searched PubMed,EMBASE,and Cochrane Central through April 2025 for studies comparing clinical outcomes in coronary artery disease(CAD)patients without a prior diabetes diagnosis,stratified by HbA1c levels(≥5.7% vs<5.7%).Risk ratios(RR)with 95%confidence intervals(CI)were pooled using a random-effects model.Statistical analysis was performed using R software(version 4.3.2).Primary outcomes were long-term allcause mortality and major adverse cardiovascular events(MACE);secondary outcomes included short-term mortality and cardiac death.RESULTS Ten studies involving 32403 patients(mean age:60 years;29% female)were included.Elevated HbA1c levels in patients without diagnosed diabetes were significantly associated with increased risk of long-term all-cause mortality(RR:1.30;95% CI:1.10-1.54;P<0.01;I2=41%)and MACEs(RR:1.31;95% CI:1.01-1.69;P=0.04;I2=61%).Although the risks of short-term all-cause mortality(RR:1.16;95% CI:0.88-1.53;P=0.29;I2=1%)and cardiac mortality(RR:1.76;95% CI:0.85-3.67;P=0.13;I2=94%)were elevated,they did not reach statistical significance.Sensitivity analyses confirmed the robustness of the findings despite moderate to high heterogeneity in some outcomes.CONCLUSION Among CAD patients without diagnosed diabetes,elevated HbA1c levels in the prediabetic range(≥5.7%)are independently associated with worse long-term outcomes following PCI.HbA1c may serve as a valuable biomarker for post-PCI risk stratification in this metabolically at-risk group.展开更多
Liver cancer presents unique challenges due to its systemic impact and complex treatment modalities.Patients often experience a range of complications,including cardiovascular,renal,hematological,and metabolic abnorma...Liver cancer presents unique challenges due to its systemic impact and complex treatment modalities.Patients often experience a range of complications,including cardiovascular,renal,hematological,and metabolic abnormalities,which can significantly affect treatment outcomes and quality of life.This article emphasizes the integration of multidisciplinary strategies and artificial intelligence-driven diagnostics,which have the potential to improve patient outcomes by optimizing early detection and targeted management of these complications.A recent study on 60 liver cancer patients undergoing interventional therapy highlighted the importance of recognizing and managing these complications.This article offers an overview of systemic complications in liver cancer,focusing on pathophysiological mechanisms,risk factors,and strategies to improve care.By addressing gaps in the existing literature and proposing future research directions,it underscores the importance of comprehensive,patient-centered approaches to refine therapeutic strategies.展开更多
Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society,being mainly represented by major depressive disorder(MDD)and bipolar disorder(BD).The etiopathogenesis of mood disord...Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society,being mainly represented by major depressive disorder(MDD)and bipolar disorder(BD).The etiopathogenesis of mood disorders is extremely complex,with a wide spectrum of biological,psychological,and sociocultural factors being responsible for their appearance and development.In this sense,immune system dysfunction represents a key mechanism in the onset and pathophysiology of mood disorders,worsening mainly the central nervous system(neuroinflammation)and the periphery of the body(systemic inflammation).However,these alterations cannot be understood separately,but as part of a complex picture in which different factors and systems interact with each other.Psychoneuroimmunoendocrinology(PNIE)is the area responsible for studying the relationship between these elements and the impact of mind–body integration,placing the immune system as part of a whole.Thus,the dysfunction of the immune system is capable of influencing and activating different mechanisms that promote disruption of the psyche,damage to the nervous system,alterations to the endocrine and metabolic systems,and disruption of the microbiota and intestinal ecosystem,as well as of other organs and,in turn,all these mechanisms are responsible for inducing and enhancing the immune dysfunction.Similarly,the clinical approach to these patients is usually multidisciplinary,and the therapeutic arsenal includes different pharmacological(for example,antidepressants,antipsychotics,and lithium)and non-pharmacological(i.e.,psychotherapy,lifestyle,and electroconvulsive therapy)treatments.These interventions also modulate the immune system and other elements of the PNIE in these patients,which may be interesting to understand the therapeutic success or failure of these approaches.In this sense,this review aims to delve into the relationship between immune dysfunction and mood disorders and their integration in the complex context of PNIE.Likewise,an attempt will be made to explore the effects on the immune system of different strategies available in the clinical approach to these patients,in order to identify the mechanisms described and their possible uses as biomarkers.展开更多
To the Editor:As a student actively involved in advocacy for heart disease prevention,I was particularly intrigued by the policymaking implications of digital interventions in the article "Digital components and ...To the Editor:As a student actively involved in advocacy for heart disease prevention,I was particularly intrigued by the policymaking implications of digital interventions in the article "Digital components and interaction types in counseling interventions for childhood and adolescent obesity:A systematic review" [1].Through my work as the Founder and President of the nonprofit Guardians of Heart,I have developed and promoted early educational programs,digital tools,and community outreach initiatives designed to instill heart-healthy habits in youth,intending to mitigate risk factors such as obesity that significantly contribute to cardiovascular disease later in life.展开更多
Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.T...Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.The study aim was to determine clinical characteristics,risk of adverse cardiovascular events,and mortality in patients aged≥85 years compared to those aged<85 undergoing PCI.Methods In this retrospective study,data were obtained from the nationwide Netherlands Heart Registration on patients undergoing PCI between January 1st,2017 and January 1st,2021.The primary endpoint was all-cause mortality at long-term followup.Results A total of 155,683 patients underwent PCI,of which 100,209(64.4%)acute coronary syndrome cases.Compared to patients aged<85 years,patients aged≥85 were more often female and showed a higher number of cardiovascular comorbidities,including impaired left ventricle ejection fraction and reduced kidney function.Mortality at short-term and long-term follow-up were significantly higher in those aged≥85(P<0.001).Patients aged≥85 were more likely to have a myocardial infarction within 30 days following the index intervention(0.9%vs.0.7%;P=0.024),though they less often underwent revascularization at longterm follow-up compared to patients aged<85(P<0.001).Conclusions The elderly(≥85 years)patient requiring PCI carries an extensive cardiovascular risk profile,translating in significant risk of recurrent cardiovascular events and increased mortality rate.Clinicians should carefully weigh perceived risks and potential benefits in the individual patient,considering the patients’age,cardiovascular risk profile,and associated risk of morbidity and mortality.展开更多
The important work of Yu,et al.[1]who presented one of the first randomized controlled trials(RCTs)to directly compare robot-assisted and manual percutaneous coronary intervention(PCI),is commendable;offering importan...The important work of Yu,et al.[1]who presented one of the first randomized controlled trials(RCTs)to directly compare robot-assisted and manual percutaneous coronary intervention(PCI),is commendable;offering important insights into the feasibility and outcomes of this emerging technology.While the analysis is timely,several issues warrant further consideration.展开更多
Deep learning has undeniably sharpened our ability to forecast risk in neuropsychiatry[1].Yet the very success of prediction has exposed a deeper limitation:we are still remarkably uncertain about which levers to pull...Deep learning has undeniably sharpened our ability to forecast risk in neuropsychiatry[1].Yet the very success of prediction has exposed a deeper limitation:we are still remarkably uncertain about which levers to pull to change patient trajectories[2].Accurate risk scores that cannot be translated into credible actions leave clinicians where they began,testing symptomatic fixes and hoping for the best.If we want to move beyond this impasse,the next step is not simply to train larger models,but to rethink what we ask of them.展开更多
Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neu...Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neurodegenerative and demyelinating diseases(Borst et al.,2021).Together with infiltrating monocyte-derived macrophages,microglia also play a critical role for brain tumor development,since immunosuppressive interactions between tumor cells and tumor-associated microglia and macrophages(TAM)are linked to malignant progression.This mechanism is of particular relevance in glioblastoma(GB),the deadliest form of brain cancer with a median overall survival of less than 15 months(Khan et al.,2023).Therefore,targeting microglia and macrophage activation is a promising strategy for therapeutic interference in brain disease.展开更多
Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general ...Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general review was conducted with primary caregivers of children younger than 18 with T1D as the population of interest.Journal searches were performed using the CINAHL,EBSCO,Pub Med,Scopus,Science Direct,and Google Scholar,databases for publications between 2017 and 2024,with full text in English.Results:A total of 26 studies were included in the review.Nine of these studies focused on various educational interventions,both technology-based and non-technology-based.By contrast,17 studies examined the impact of these interventions on caregiver outcomes,such as treatment adherence and glycemic control in children with T1D.So,the following research questions guided this review:(1)What is the effectiveness of diabetes education interventions on glycemic control in children with T1D?(2)How do caregiver knowledge and self-efficacy affect diabetes management outcomes?Conclusions:Diabetes interventions highlight the vital role of empowering caregivers of children with T1D with knowledge,skills,and support to improve and enhance their adherence to treatment,knowledge,and self-efficacy that ultimately contribute to better glycemic control of children as reflected by their Hb A1c levels.This review highlights the importance of diabetes education interventions for caregivers of children with T1D.The evidence indicates that such interventions can improve caregiver knowledge,self-efficacy,and glycemic control in children.However,variability in outcomes suggests that fur ther research is needed to identify the most effective educational strategies.展开更多
Background: The human gut microbiome is an important target for disease treatment and prevention. Various microbial species within the complex ecosystem of the microbiome have been shown to play important roles in dis...Background: The human gut microbiome is an important target for disease treatment and prevention. Various microbial species within the complex ecosystem of the microbiome have been shown to play important roles in disease. Identification of bioactive materials capable of altering the abundances of these species both safely and effectively is a major goal in microbiome research. Many traditional Chinese medicines (TCMs) have been reported to affect the composition of the gut microbiome. Here, we summarize studies that have used TCMs to alter the gut microbiome and discuss the response relationship between TCMs and gut microbial species. Methods: We searched the PubMed, Web of Science, and Knowledge Network databases using the terms “traditional Chinese medicine,” “gut microbiome,” and specific system disease names (endocrine, immune, nervous, cardiovascular, and digestive). Studies were excluded if irrelevant or if the experimental procedures were unclear. Results: TCMs have been reported to affect a wide range of gut microbial taxa spanning major phyla, including Firmicutes, Bacteroidetes, Proteobacteria, Verrucomicrobiota, Actinobacteria, and Fusobacteria. In all, 54 TCMs including compounds and extracts have been tested in rodents and 30 have been examined in human trials. Almost all studies have reported positive results in regulating the gut microbiome as well as modulating corresponding phenotypes, spanning diseases of the endocrine, immune, nervous, cardiovascular, and digestive systems. Gut species, including Akkermansia, Bacteroides, Fusobacterium, Faecalibacterium, and E. coli, were found to be regulated by 19 TCMs. A network was constructed to visualize the interactions between TCMs and these taxa. Conclusion: There exists a complex and close relationship between intestinal microflora and diseases. Sufficient experimental data and studies have proved that the imbalance of intestinal microflora affects health by mediating metabolism, immune regulation, inflammation and signal transduction. Many characteristic alterations of intestinal microflora are positively correlated with diseases, so intestinal microflora has become a potential risk index and treatment target for many diseases. Many TCMs affect the relative abundances of microbial species in the gut, and therefore may be useful for modulating the gut microbiome. This review provides a reference for prioritizing candidate TCMs from the enormous repertoire of such medicines to test which specific gut microbes are targeted.展开更多
Objective:To explore the intervention effect of comprehensive perioperative blood glucose management on patients with diabetes complicated with cataract surgery.Method:A total of 68 patients in our hospital from July ...Objective:To explore the intervention effect of comprehensive perioperative blood glucose management on patients with diabetes complicated with cataract surgery.Method:A total of 68 patients in our hospital from July 2024 to July 2025 were selected and randomly divided into the experimental group and the control group,with 34 cases in each group.The control group received routine blood glucose management,while the experimental group,on this basis,implemented individualized intervention 3 days before the operation,real-time regulation during the operation,dynamic management 7 days after the operation,and self-management training.Result:The blood glucose control in the experimental group was more stable 7 days after the operation.The total incidence of complications(2.9%)was significantly lower than that in the control group(38.2%),and the average hospital stay(5.1±1.0 days)was shorter than that in the control group(7.3±1.4 days).One week after the operation,the proportions of uncorrected visual acuity and visual acuity≥0.6(67.6%)were both better than those of the control group(p<0.001).Conclusion:The whole-course management of perioperative blood glucose can enhance the stability of blood glucose control,reduce the risk of complications,shorten the length of hospital stay,promote visual recovery,and has high clinical promotion value.展开更多
The post-hoc analysis of the PERSEO registry by Minardi,et al.[1]offers critical insights into antithrombotic management for elderly patients(≥80 years)on oral anticoagulation undergoing percutaneous coronary interve...The post-hoc analysis of the PERSEO registry by Minardi,et al.[1]offers critical insights into antithrombotic management for elderly patients(≥80 years)on oral anticoagulation undergoing percutaneous coronary intervention.While the authors effectively demonstrate the vulnerability of this population,characterized by substantial comorbidity burden and markedly elevated rates of mortality,ischemic events,and bleeding at one year compared with younger cohorts,their findings raise important questions about contemporary practice patterns and their alignment with evidence-based guidelines.展开更多
基金supported by the Jiangsu Provincial Department of Science and Technology,China(No.BE2022773).
文摘Background:A systematic evaluation and meta-analysis of randomized controlled trials(RCTs)was conducted to assess the impact of immunonutritional interventions on sarcopenia in oncology patients.Methods:A computerized search of the PubMed,Embase,the Cochrane Library,and Web of Science databases was performed.The studies included in the final analyses encompassed 7 high-quality RCTs,involving 432 tumor patients.The intervention group received immunonutritional supplements enriched with omega-3 fatty acids,arginine,glutamine,and other nutrients.The control group received a standard diet or a placebo.Primary outcome indicators included muscle mass,body weight,body mass index(BMI),inflammatory markers[e.g.,C-reactive protein(CRP),interleukin(IL)-6],and patient prognosis.The study followed the PRISMA 2020 guidelines.Results:Meta-analyses showed that immunonutritional interventions reduced IL-6 levels compared with the control group(mean=-5.85,95%CI:-10.88 to -0.82,P=0.02).No significant differences were observed in the body weight(mean=-1.50,95%CI:-6.24 to 3.24,I^(2)=0,P=0.54),BMI(mean=-0.38,95%CI:-1.84 to 1.09,I^(2)=0,P=0.61),handgrip strength(mean=1.97,95%CI:-2.94 to 6.88,I^(2)=0,P=0.43),or fat tissue index(mean=0.70,95%CI:-0.56 to 1.97,I^(2)=0,P=0.27).CRP levels showed a nonsignificant downward trend in the intervention group(mean=-4.13,95%CI:-13.63 to 5.38,I^(2)=66%,P=0.39),with high heterogeneity potentially attributable to differences in trial design,patients’baseline status,and intervention methods.Risk of bias assessment confirmed the high quality of the included studies.Conclusions:Immunonutritional interventions may modulate inflammatory responses in oncology patients,particularly those at higher nutritional risk,but their effect on enhancing muscle mass was not statistically confirmed.Impacts on body weight and BMI remain ambiguous,potentially influenced by factors such as the specific intervention administered,its duration,the concentrations of the different components,and the patients’baseline status.This study provides preliminary support for immunonutrition in managing sarcopenia in oncology patients;however,additional high-quality RCTs with larger sample sizes and standardized protocols are needed to further substantiate the efficacy and safety of the interventions,thereby providing a more robust evidence-based foundation for clinical practice.
文摘Objective:To explore the impact of systematic stepwise rehabilitation nursing intervention on the prognosis and disease uncertainty of patients with hypertensive intracerebral hemorrhage,and to provide feasible strategies for clinical nursing.Methods:Eighty patients with hypertensive intracerebral hemorrhage admitted to our hospital from January 2023 to June 2025 were selected and randomly divided into an observation group(n=40,receiving systematic stepwise rehabilitation nursing)and a control group(n=40,receiving conventional nursing).The intervention effects were analyzed by comparing changes in the National Institutes of Health Stroke Scale(NIHSS)scores for neurological recovery,Short Form 36 Health Survey(SF-36)scores for quality of life,Exercise of Self-Care Agency Scale(ESCA)scores for self-management ability,compliance,and the Mishel Uncertainty in Illness Scale(MUIS)scores between the two groups.Results:All scores in the observation group were significantly better than those in the control group after the intervention(p<0.05).Specifically,the NIHSS scores decreased more significantly,the total SF-36 scores increased,the ESCA scores increased significantly,while the MUIS scores decreased significantly,and compliance improved markedly,indicating a reduction in disease uncertainty among patients.Conclusion:Systematic stepwise rehabilitation nursing intervention can significantly improve neurological recovery,quality of life,self-management ability,and compliance in patients with hypertensive intracerebral hemorrhage,while effectively reducing disease uncertainty.It is worthy of clinical promotion and application.
文摘Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interventions have been shown to help students develop healthy stress coping strategies.The purpose of this systematic review and meta-analysis was to examine the diverse array of coping interventions and what characteristics of coping interventions were most effective at decreasing stress among healthcare students.Methods:Any intervention designed to address coping for academic stress was included among medical,dental,nursing,physician assistant,allied health,veterinary,psychology,etc.students.A comprehensive literature search was completed to include multiple databases,Ancestry,and hand-searching from EBSCO and Google Scholar articles.A final total of 17 studies were included.Standardized mean difference effect sizes(ES)were synthesized across studies using a random-effects model in the Comprehensive Meta-Analysis Software for changes in coping levels in healthcare students.Moderator analyses were performed to explore the study,intervention,and participants’characteristics.The risk of bias was assessed by RoB2 and ROBINS-I.Results:Coping interventions significantly reduced stress outcomes among healthcare students(d=0.74;95%CI[0.48–1.01],95%PI[−0.41–1.90],p<0.001,Q=228.49,I^(2)=93.0%,T=0.52,T^(2)=0.28,p<0.001).Moderator analysis showed that interventions with stress education,established professional guidance,and fewer hours led to better stress management outcomes.Conclusions:This study demonstrates that coping interventions produce an overall moderate-to-large effect on stress reduction.Future research investigating coping interventions on academic and long-term outcomes would be beneficial.
文摘BACKGROUND Urolithiasisposes challenges in patients with chronic kidney disease(CKD),necessitating careful consideration of surgical interventions due to potential complications.AIM To assess the safety,feasibility,and efficacy of surgical interventions for urolithiasis in CKD patients.METHODS Systematic review adhering to PRISMA guidelines.Comprehensive searches of PubMed,Scopus,Cochrane Library,Web of Science,and Embase were conducted for studies published from January 2014 to June 2024.Studies involving adult patients(≥18 years)with CKD undergoing surgical interventions for urolithiasis,including randomized controlled trials,cohort studies,case-control studies,and observational studies.Studies involving pediatric patients,those not specifically addressing CKD patients,review articles,commentaries,and editorials.Despite an extensive search,only six studies met the strict inclusion criteria,reflecting the limited available data on this topic.This limitation has been acknowledged and discussed.RESULTS A total of 6 studies met the inclusion criteria,encompassing a diverse range of surgical interventions such as percutaneous nephrolithotomy(PCNL),ureteroscopy(URS),and extracorporeal shock wave lithotripsy(ESWL).Perioperative and postoperative complications varied across studies,with bleeding,infection,and acute kidney injury being the most common.The risk of complications was higher in patients with advanced CKD.Technical success rates were generally high,but feasibility was influenced by patientspecific factors such as CKD stage and comorbidities.Modifications to standard surgical techniques were often necessary.Stone-free rates and recurrence rates varied,with PCNL generally achieving higher stone-free rates compared to URS and ESWL.Long-term outcomes on renal function were inconsistent,highlighting the need for individualized treatment plans.CONCLUSION Surgical interventions for urolithiasis in CKD patients are associated with significant risks but can be effective in achieving stone clearance and symptom relief.The safety,feasibility,and efficacy of these interventions depend on patient-specific factors,necessitating a tailored approach.Further high-quality studies are needed to develop standardized guidelines and improve clinical outcomes in this complex patient population.
文摘Objective:To assess the method of empathy intervention in nursing students in relation to the three dimensions of empathy:cognitive,affective,and behavioral.Methods:A systematic literature review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)2020 guideline.A search for articles in two databases(ScienceDirect and Taylor&Francis)revealed 99 articles.One author independently assessed articles for inclusion,resulting in 10 articles that met the inclusion criteria.Results:Based on a review of ten extracted journal articles,nine interventions showed increases in empathy,while one intervention did not show such outcomes.Four studies(the simulation-based empathic communication training intervention,the situated teaching program,high-fidelity simulation[HFS]training,and the structured empathy educational model[EEM])discussed the impact of interventions on the empathy dimension,while the remaining five only explained the impact of the intervention on empathy in general.Conclusions:The result of this study highlight the need for future research to design empathy interventions for nursing students that effectively target both the affective and behavioral dimensions of empathy.
文摘BACKGROUND Postpartum depression(PPD)is a prevalent and debilitating psychiatric disorder affecting maternal mental health,infant development,and family well-being.Despite increasing global awareness,significant disparities remain in screening,diagnosis,and treatment,particularly in low-resource and culturally diverse settings.The complex interplay of biological and psychosocial determinants complicates conventional intervention models.Integrating epidemiological patterns,pathophysiological mechanisms,and sociocultural factors will inform more effective and equitable strategies for PPD screening,prevention,and treatment.METHODS A narrative review was conducted following PRISMA 2020 guidelines.Peer-reviewed studies published from January 2010 to May 2025 were systematically searched in PubMed,Web of Science,EMBASE,and PsycINFO.Inclusion criteria comprised studies addressing PPD epidemiology,risk stratification,biological mechanisms,and intervention strategies.After screening and full-text review,84 studies were included.Study designs primarily involved cohort studies,randomized controlled trials,and meta-analyses.Extracted data were categorized thematically and assessed for methodological quality and generalizability.RESULTS PPD arises from multifactorial interactions involving hormonal dysregulation,neurochemical changes,psychosocial stressors,and cultural influences.Primary risk factors include personal or family history of depression,antenatal anxiety,low maternal self-efficacy,and inadequate social support.Evidence-based interventions encompass Edinburgh Postnatal Depression Scale-based screening,cognitive behavioral therapy,interpersonal psychotherapy,psychoeducation,and pharmacological treatments such as brexanolone and zuranolone.Culturally adapted,community-integrated models—including stepped-care approaches and task-shifting—improve feasibility and scalability,particularly in underserved populations.Emerging evidence highlights inflammatory biomarkers(e.g.,interleukin-6 and C-reactive protein),AI-assisted screening tools,and family-inclusive strategies as promising for enhanced detection and outcomes.CONCLUSION Effective PPD management requires integrative,culturally sensitive approaches,prioritizing scalable,personalized non-pharmacological interventions to reduce disparities and enhance maternal mental health equity across diverse populations.
文摘Purpose:This study aimed to provide comparative evidence on the effectiveness of various lifestyle interventions on body composition management for preschool and school-aged children.Methods:PubMed(MEDLINE),Embase,CINAHL,and Web of Science were systematically searched for this network meta-analysis.Randomized controlled studies(RCTs)that included children aged 4-12 years with no physical or mental conditions;performed at least 1 type of lifestyle intervention;reported change in body mass index(BMI),BMI z-score,or body fat percentage(BFP);and were published between January2010 and August 2023 were included.Results:The final analysis included 91 RCTs with aggregate data for 58,649 children.All interventions were categorized into single-arm approaches(physical activity,diet,and behavioral and informational support)and combined arms approaches(bicomponent and multicomponent treatment).Multicomponent treatment showed significant effectiveness on the reduction of BMI(mean deviation(MD)-0.49,95%confidence interval(95%CI):-0.88 to-0.12),BMI z-score(MD=-0.11,95%CI:-0.18 to-0.04),and BFP(MD=-1.69,95%CI:-2.97 to-0.42)compared to the usual care condition.Bicomponent treatment also significantly reduced BMI(MD=-0.28,95%CI:-0.54 to-0.04)and BMI z-score(MD=-0.07,95%CI:-0.12 to-0.02)compared to usual care.Conclusion:Interventions targeting multiple lifestyle components achieved greater reductions in children's BMI and BFP.Among single-component approaches,physical activity engagement emerged as the most effective.These findings should guide practitioners in recommending comprehensive lifestyle modifications for children.Moreover,children with higher initial BMI and body fat levels tend to exhibit more positive responses to lifestyle interventions aimed at managing obesity.
文摘Background:Foreign Language Anxiety(FLA)represents a substantial affective barrier that undermines cognitive performance,motivation,and retention in language learners.Emerging evidence highlights mindfulness-based interventions as promising strategies for enhancing emotional regulation and reducing anxiety across educational contexts.This review synthesizes current research on mindfulness as a psychological intervention,aims to evaluate its efficacy in alleviating FLA,and discusses its broader implications for health-focused educational policy and practice.Methods:Following PRISMA guidelines,we systematically reviewed studies examining the relationships between mindfulness and FLA.Our search of four major databases(November 2023)initially identified 346 articles using terms like“mindfulness AND language anxiety.”After screening,14 studies met our criteria:(1)empirical research in English on mindfulness-FLA relationships;(2)no publication date restrictions.Two independent reviewers selected studies,excluding two due to methodological limitations.We conducted a narrative synthesis given the study heterogeneity(9 correlational and 5 intervention studies).Results:9 non-intervention studies demonstrated that mindfulness is negatively associated with FLA,with 3 studies highlighting the mediating roles of self-efficacy and resilience.5 intervention studies reported inconsistent results regarding the efficacy of mindfulness-based interventions in reducing FLA.Conclusions:The findings suggest that while mindfulness holds promise as a tool to address FLA,its mechanisms and effectiveness require further investigation.This study underscores the need for rigorous research,including Randomized Controlled Trials(RCTs),to inform evidence-based integration of mindfulness into foreign language curricula.For educational policymakers and practitioners,these insights highlight the importance of adopting mindfulness interventions cautiously,ensuring they are tailored to students’needs and supported by evidence.
文摘BACKGROUND Glycated hemoglobin(HbA1c)is a well-established biomarker for diagnosing and managing diabetes.However,its prognostic significance in patients without diagnosed diabetes undergoing percutaneous coronary intervention(PCI)remains uncertain.This systematic review and meta-analysis evaluates the association between elevated HbA1c levels in the prediabetic range(≥5.7%)and adverse cardiovascular outcomes in this population.AIM To investigate the association between elevated HbA1c levels in the prediabetic range and adverse outcomes in patients without diagnosed diabetes undergoing PCI.METHODS We systematically searched PubMed,EMBASE,and Cochrane Central through April 2025 for studies comparing clinical outcomes in coronary artery disease(CAD)patients without a prior diabetes diagnosis,stratified by HbA1c levels(≥5.7% vs<5.7%).Risk ratios(RR)with 95%confidence intervals(CI)were pooled using a random-effects model.Statistical analysis was performed using R software(version 4.3.2).Primary outcomes were long-term allcause mortality and major adverse cardiovascular events(MACE);secondary outcomes included short-term mortality and cardiac death.RESULTS Ten studies involving 32403 patients(mean age:60 years;29% female)were included.Elevated HbA1c levels in patients without diagnosed diabetes were significantly associated with increased risk of long-term all-cause mortality(RR:1.30;95% CI:1.10-1.54;P<0.01;I2=41%)and MACEs(RR:1.31;95% CI:1.01-1.69;P=0.04;I2=61%).Although the risks of short-term all-cause mortality(RR:1.16;95% CI:0.88-1.53;P=0.29;I2=1%)and cardiac mortality(RR:1.76;95% CI:0.85-3.67;P=0.13;I2=94%)were elevated,they did not reach statistical significance.Sensitivity analyses confirmed the robustness of the findings despite moderate to high heterogeneity in some outcomes.CONCLUSION Among CAD patients without diagnosed diabetes,elevated HbA1c levels in the prediabetic range(≥5.7%)are independently associated with worse long-term outcomes following PCI.HbA1c may serve as a valuable biomarker for post-PCI risk stratification in this metabolically at-risk group.
文摘Liver cancer presents unique challenges due to its systemic impact and complex treatment modalities.Patients often experience a range of complications,including cardiovascular,renal,hematological,and metabolic abnormalities,which can significantly affect treatment outcomes and quality of life.This article emphasizes the integration of multidisciplinary strategies and artificial intelligence-driven diagnostics,which have the potential to improve patient outcomes by optimizing early detection and targeted management of these complications.A recent study on 60 liver cancer patients undergoing interventional therapy highlighted the importance of recognizing and managing these complications.This article offers an overview of systemic complications in liver cancer,focusing on pathophysiological mechanisms,risk factors,and strategies to improve care.By addressing gaps in the existing literature and proposing future research directions,it underscores the importance of comprehensive,patient-centered approaches to refine therapeutic strategies.
基金supported by the Instituto de Salud Carlos III(EstataldeI+D+I2020-2027)co-financed by the European Development Regional Fund“A way to achieve Europe”P2022/BMD-7321(Comunidad de Madrid)and ProACapital,Halekulani S.L.and MJR.
文摘Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society,being mainly represented by major depressive disorder(MDD)and bipolar disorder(BD).The etiopathogenesis of mood disorders is extremely complex,with a wide spectrum of biological,psychological,and sociocultural factors being responsible for their appearance and development.In this sense,immune system dysfunction represents a key mechanism in the onset and pathophysiology of mood disorders,worsening mainly the central nervous system(neuroinflammation)and the periphery of the body(systemic inflammation).However,these alterations cannot be understood separately,but as part of a complex picture in which different factors and systems interact with each other.Psychoneuroimmunoendocrinology(PNIE)is the area responsible for studying the relationship between these elements and the impact of mind–body integration,placing the immune system as part of a whole.Thus,the dysfunction of the immune system is capable of influencing and activating different mechanisms that promote disruption of the psyche,damage to the nervous system,alterations to the endocrine and metabolic systems,and disruption of the microbiota and intestinal ecosystem,as well as of other organs and,in turn,all these mechanisms are responsible for inducing and enhancing the immune dysfunction.Similarly,the clinical approach to these patients is usually multidisciplinary,and the therapeutic arsenal includes different pharmacological(for example,antidepressants,antipsychotics,and lithium)and non-pharmacological(i.e.,psychotherapy,lifestyle,and electroconvulsive therapy)treatments.These interventions also modulate the immune system and other elements of the PNIE in these patients,which may be interesting to understand the therapeutic success or failure of these approaches.In this sense,this review aims to delve into the relationship between immune dysfunction and mood disorders and their integration in the complex context of PNIE.Likewise,an attempt will be made to explore the effects on the immune system of different strategies available in the clinical approach to these patients,in order to identify the mechanisms described and their possible uses as biomarkers.
文摘To the Editor:As a student actively involved in advocacy for heart disease prevention,I was particularly intrigued by the policymaking implications of digital interventions in the article "Digital components and interaction types in counseling interventions for childhood and adolescent obesity:A systematic review" [1].Through my work as the Founder and President of the nonprofit Guardians of Heart,I have developed and promoted early educational programs,digital tools,and community outreach initiatives designed to instill heart-healthy habits in youth,intending to mitigate risk factors such as obesity that significantly contribute to cardiovascular disease later in life.
文摘Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.The study aim was to determine clinical characteristics,risk of adverse cardiovascular events,and mortality in patients aged≥85 years compared to those aged<85 undergoing PCI.Methods In this retrospective study,data were obtained from the nationwide Netherlands Heart Registration on patients undergoing PCI between January 1st,2017 and January 1st,2021.The primary endpoint was all-cause mortality at long-term followup.Results A total of 155,683 patients underwent PCI,of which 100,209(64.4%)acute coronary syndrome cases.Compared to patients aged<85 years,patients aged≥85 were more often female and showed a higher number of cardiovascular comorbidities,including impaired left ventricle ejection fraction and reduced kidney function.Mortality at short-term and long-term follow-up were significantly higher in those aged≥85(P<0.001).Patients aged≥85 were more likely to have a myocardial infarction within 30 days following the index intervention(0.9%vs.0.7%;P=0.024),though they less often underwent revascularization at longterm follow-up compared to patients aged<85(P<0.001).Conclusions The elderly(≥85 years)patient requiring PCI carries an extensive cardiovascular risk profile,translating in significant risk of recurrent cardiovascular events and increased mortality rate.Clinicians should carefully weigh perceived risks and potential benefits in the individual patient,considering the patients’age,cardiovascular risk profile,and associated risk of morbidity and mortality.
文摘The important work of Yu,et al.[1]who presented one of the first randomized controlled trials(RCTs)to directly compare robot-assisted and manual percutaneous coronary intervention(PCI),is commendable;offering important insights into the feasibility and outcomes of this emerging technology.While the analysis is timely,several issues warrant further consideration.
文摘Deep learning has undeniably sharpened our ability to forecast risk in neuropsychiatry[1].Yet the very success of prediction has exposed a deeper limitation:we are still remarkably uncertain about which levers to pull to change patient trajectories[2].Accurate risk scores that cannot be translated into credible actions leave clinicians where they began,testing symptomatic fixes and hoping for the best.If we want to move beyond this impasse,the next step is not simply to train larger models,but to rethink what we ask of them.
基金Deutsche Forschungsgemeinschaft(DFG,German Research Foundation),project numbers 324633948 and 409784463(DFG grants Hi 678/9-3 and Hi 678/10-2,FOR2953)to HHBundesministerium für Bildung und Forschung-BMBF,project number 16LW0463K to HT.
文摘Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neurodegenerative and demyelinating diseases(Borst et al.,2021).Together with infiltrating monocyte-derived macrophages,microglia also play a critical role for brain tumor development,since immunosuppressive interactions between tumor cells and tumor-associated microglia and macrophages(TAM)are linked to malignant progression.This mechanism is of particular relevance in glioblastoma(GB),the deadliest form of brain cancer with a median overall survival of less than 15 months(Khan et al.,2023).Therefore,targeting microglia and macrophage activation is a promising strategy for therapeutic interference in brain disease.
文摘Objective:This review aimed to evaluate existing evidence of educational interventions targeted at parents and caregivers of children with type 1 diabetes(T1D)to improve diabetes management outcomes.Methods:A general review was conducted with primary caregivers of children younger than 18 with T1D as the population of interest.Journal searches were performed using the CINAHL,EBSCO,Pub Med,Scopus,Science Direct,and Google Scholar,databases for publications between 2017 and 2024,with full text in English.Results:A total of 26 studies were included in the review.Nine of these studies focused on various educational interventions,both technology-based and non-technology-based.By contrast,17 studies examined the impact of these interventions on caregiver outcomes,such as treatment adherence and glycemic control in children with T1D.So,the following research questions guided this review:(1)What is the effectiveness of diabetes education interventions on glycemic control in children with T1D?(2)How do caregiver knowledge and self-efficacy affect diabetes management outcomes?Conclusions:Diabetes interventions highlight the vital role of empowering caregivers of children with T1D with knowledge,skills,and support to improve and enhance their adherence to treatment,knowledge,and self-efficacy that ultimately contribute to better glycemic control of children as reflected by their Hb A1c levels.This review highlights the importance of diabetes education interventions for caregivers of children with T1D.The evidence indicates that such interventions can improve caregiver knowledge,self-efficacy,and glycemic control in children.However,variability in outcomes suggests that fur ther research is needed to identify the most effective educational strategies.
基金funding by National Natural Science Foundation of China(No.82174492)National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion Project(N o.ZJJBGS2024002-1).
文摘Background: The human gut microbiome is an important target for disease treatment and prevention. Various microbial species within the complex ecosystem of the microbiome have been shown to play important roles in disease. Identification of bioactive materials capable of altering the abundances of these species both safely and effectively is a major goal in microbiome research. Many traditional Chinese medicines (TCMs) have been reported to affect the composition of the gut microbiome. Here, we summarize studies that have used TCMs to alter the gut microbiome and discuss the response relationship between TCMs and gut microbial species. Methods: We searched the PubMed, Web of Science, and Knowledge Network databases using the terms “traditional Chinese medicine,” “gut microbiome,” and specific system disease names (endocrine, immune, nervous, cardiovascular, and digestive). Studies were excluded if irrelevant or if the experimental procedures were unclear. Results: TCMs have been reported to affect a wide range of gut microbial taxa spanning major phyla, including Firmicutes, Bacteroidetes, Proteobacteria, Verrucomicrobiota, Actinobacteria, and Fusobacteria. In all, 54 TCMs including compounds and extracts have been tested in rodents and 30 have been examined in human trials. Almost all studies have reported positive results in regulating the gut microbiome as well as modulating corresponding phenotypes, spanning diseases of the endocrine, immune, nervous, cardiovascular, and digestive systems. Gut species, including Akkermansia, Bacteroides, Fusobacterium, Faecalibacterium, and E. coli, were found to be regulated by 19 TCMs. A network was constructed to visualize the interactions between TCMs and these taxa. Conclusion: There exists a complex and close relationship between intestinal microflora and diseases. Sufficient experimental data and studies have proved that the imbalance of intestinal microflora affects health by mediating metabolism, immune regulation, inflammation and signal transduction. Many characteristic alterations of intestinal microflora are positively correlated with diseases, so intestinal microflora has become a potential risk index and treatment target for many diseases. Many TCMs affect the relative abundances of microbial species in the gut, and therefore may be useful for modulating the gut microbiome. This review provides a reference for prioritizing candidate TCMs from the enormous repertoire of such medicines to test which specific gut microbes are targeted.
文摘Objective:To explore the intervention effect of comprehensive perioperative blood glucose management on patients with diabetes complicated with cataract surgery.Method:A total of 68 patients in our hospital from July 2024 to July 2025 were selected and randomly divided into the experimental group and the control group,with 34 cases in each group.The control group received routine blood glucose management,while the experimental group,on this basis,implemented individualized intervention 3 days before the operation,real-time regulation during the operation,dynamic management 7 days after the operation,and self-management training.Result:The blood glucose control in the experimental group was more stable 7 days after the operation.The total incidence of complications(2.9%)was significantly lower than that in the control group(38.2%),and the average hospital stay(5.1±1.0 days)was shorter than that in the control group(7.3±1.4 days).One week after the operation,the proportions of uncorrected visual acuity and visual acuity≥0.6(67.6%)were both better than those of the control group(p<0.001).Conclusion:The whole-course management of perioperative blood glucose can enhance the stability of blood glucose control,reduce the risk of complications,shorten the length of hospital stay,promote visual recovery,and has high clinical promotion value.
文摘The post-hoc analysis of the PERSEO registry by Minardi,et al.[1]offers critical insights into antithrombotic management for elderly patients(≥80 years)on oral anticoagulation undergoing percutaneous coronary intervention.While the authors effectively demonstrate the vulnerability of this population,characterized by substantial comorbidity burden and markedly elevated rates of mortality,ischemic events,and bleeding at one year compared with younger cohorts,their findings raise important questions about contemporary practice patterns and their alignment with evidence-based guidelines.
