Registration Center Research Articles

Transauricular vagus nerve stimulation in preventing post-traumatic stress disorder in emergency trauma surgery patients in China: a study protocol for a multicenter, double-blind, randomised, controlled trial

IntroductionThe incidence of post-traumatic stress disorder (PTSD) in emergency trauma surgery patients is 24%, emphasising the urgent need for effective early interventions and treatments. Transauricular vagus nerve stimulation (ta-VNS) modulates...

Effects of Electrical Stimulation on Activation of Mirror Neuron Network in Healthy Adults during Motor Execution and Imitation: An fNIRS Study.

Observation, execution, and imitation of target actions based on mirror neuron network (MNN) have become common physiotherapy strategies. Electrical stimulation (ES) is a common intervention to improve muscle strength and motor control in rehabilitation treatments. It is possible to enhance MNN's activation by combining motor execution (ME) and motor imitation (MI) with ES simultaneously. This study aims to reveal whether ES could impact cortical activation during ME and MI. We recruited healthy individuals and assigned them randomly to the control group (CG) or experiment group (EG). Participants in EG performed ME and MI tasks with ES, while participants in CG performed the same two tasks with sham ES. We utilized functional near-infrared spectroscopy (fNIRS) to detect brain activation of MNN during ME and MI with and without ES, a randomized block design experiment paradigm was designed. Descriptive analysis of oxy-hemoglobin (HbO) and deoxy-hemoglobin (HbR) were used to show the hemoglobin (Hb) concentration changes after different event onsets in both CG and EG, a linear mixed-effects model (LMM) of HbO data was employed to analyze the effect of ES on the activation of MNN. A total of 102 healthy adults were recruited and 72 participants' data were analysed in the final report. The block averaged Hb data showed that HbO concentration increased and HbR concentration decreased in most MNN regions during ME and MI in both groups. The LMM results showed that ES can significantly improve the activation of inferior frontal gyrus, middle frontal gyrus, and precentral gyrus during MI, the supplementary motor area, inferior parietal lobule, and superior temporal gyri showed increased activation, but without statistical significance. Although the results did not reach statistical significance during ME, ES still showed positive effects on increased overall activations. In this study, we present potential novel rehabilitation approaches that combines MNN strategies and low-frequency ES to enhance cortical activation. Our results revealed that ES has potential to increase activation of most MNN brain areas, providing evidence for related rehabilitative interventions and device development. This study was registered on the China Clinical Trial Registration Center (identifier: ChiCTR2200064082, registered 26, September 2022, https://www.chictr.org.cn/showproj.html?proj=178285).

Effect of self-care education on self-efficacy of patients with multiple sclerosis: a randomized clinical trial

BackgroundSelf-care education is one method used to reduce the complications of chronic diseases like Multiple sclerosis which affects self-efficacy. The present study evaluated the effect of self-care training by nurses on the self-efficacy of patients with multiple sclerosis.MethodsThis is a randomized clinical trial with pre-test/ post-test. The statistical population of this study included all patients with multiple sclerosis who were members of the Iranian Multiple Sclerosis Association, from whom 90 patients were selected and divided into two groups of intervention and control (n = 45 people in each group), through a table of random numbers. First, both groups completed the demographic information and Sherer's self-efficacy questionnaire. Then, a self-care empowerment program was delivered to patients in the intervention group. Eight weeks later, the self-efficacy questionnaires were completed again by both intervention and control groups. The data were analyzed using SPSS-22 statistical software.ResultsThe mean self-efficacy score in the intervention group was (60.27 ± 8.63) and in the control group was (59.07 ± 6.84) before the intervention. After the intervention, a statistically significant difference was observed between the two groups regarding the mean self-efficacy scores (p = 0.004). The mean self-efficacy scores in the intervention and control groups were (63.73 ± 6.97) and (59.21 ± 6.23) after the intervention.ConclusionsA Self-care training program can be used as one of the methods to improve self-efficacy in patients with multiple sclerosis.Trial registrationThe protocol of this clinical trial has been registered in the Iranian Clinical Trial Registration Center (registration code: IRCT20180914041036N1). Registered 18 January 2019- Retrospectively registered, date of first recruitment: 23 August 2017, https://www.irct.ir/.

The median effective dose of ciprofol combined with sufentanil in suppressing the laryngeal mask airway insertion response in both young and older adult patients

BackgroundCiprofol, a novel intravenous anesthetic, exhibits similar sedation mechanisms and pharmacokinetic properties to propofol. However, ciprofol demonstrates greater potency and is associated with reduced injection pain compared to propofol. Given the varying sensitivities to anesthetic agents across different age groups, this study aims to determine the median effective dose (ED50) of ciprofol required to suppress the laryngeal mask airway (LMA) insertion response in both young and older adult patients, as well as to assess its potential adverse reactions.MethodsIn this study, 46 patients scheduled for surgery under general anesthesia with LMA insertion were recruited. Upon entering the operating room, patients were intravenously administered ciprofol (0.4 mg·kg− 1) and sufentanil (0.3 µg·kg− 1), followed by LMA insertion after three minutes. To derive robust confidence intervals for both ED50 and ED95, we performed an analysis using a logistic regression model combined with bootstrap resampling.ResultsIn the young adult group, the ED50 and ED95 of ciprofol for suppressing the LMA insertion response were 0.38 mg·kg− 1 (95% CI, 0.35–0.41) and 0.46 mg·kg− 1 (95%CI, 0.40–0.56), respectively. In the older adult group, the respective ED50 and ED95 were 0.29 mg·kg− 1 (95% CI, 0.26–0.32) and 0.37 mg·kg− 1 (95% CI, 0.30–0.78). Regarding adverse reactions, although there were differences in the incidence of injection pain, hypotension, and bradycardia between the young and older groups, no statistically significant differences were observed between the two groups.ConclusionIn this study, significant differences were observed in the ED50 of ciprofol for suppressing the LMA insertion response between young and older adult patients. The ED50 of ciprofol for young adult patients was 0.38 mg·kg− 1 (95% CI, 0.35–0.41), while for older adult patients it was0.29 mg·kg− 1 (95% CI, 0.26–0.32).Trial registrationThis study was registered on February 17, 2024, with the China Clinical Trial Registration Center (www.chictr.org.cn; Registration Number: ChiCTR2400080891).

The Application of Concept Map Thinking Combined with Kolcaba's Comfort Nursing in the Perioperative Care of Patients Undergoing Nasal Deformity Correction.

Aims/Background By addressing patients' physical, psychological, social, cultural, and environmental comfort needs holistically, Kolcaba's Comfort Theory raises the standard of care and increases patient satisfaction. This study explored the combined application of these nursing models during the perioperative period for patients undergoing nasal deformity correction surgery. Methods 92 patients undergoing nasal deformity correction at the Seventh Affiliated Hospital of Sun Yat-sen University were randomly divided into two groups: the conventional group (46 patients), which received standard perioperative nursing care, and the experimental group (46 patients), which received concept map thinking nursing combined with Kolcaba's comfort nursing intervention during the perioperative period. Clinical indicators, including the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Rhinoplasty Outcome Evaluation (ROE) and General Comfort Questionnaire (GCQ), were compared between the two groups at multiple time points. Results The experimental group demonstrated significantly shorter operation times (p < 0.001), faster recovery of nasal breathing (p = 0.002), and shorter hospital stays (p < 0.001) compared to the conventional group. Additionally, the experimental group experienced less intraoperative blood loss (p < 0.001) and a lower incidence of complications (p = 0.013). At 2 days, 1 month, and 3 months post-surgery, both groups showed decreases in SAS, SDS, and PSQI scores, with the experimental group demonstrating significantly lower scores (p < 0.05). At these same time points, the ROE and GCQ scores increased in both groups, with the experimental group achieving significantly higher scores than the conventional group (p < 0.05). Conclusion The integration of concept map thinking with Kolcaba's comfort nursing significantly improves the postoperative recovery of patients undergoing nasal deformity correction. Reduced surgical trauma, enhanced psychological health, better sleep, increased comfort, and quicker nasal function recovery are all results of this method. Clinical Trial Registration China Clinical Trial Registration Center (https://www.chictr.org.cn/showproj.html?proj=191278).

Investigating autonomic dysfunction in post-COVID-19 syndrome from skin to brain: A case-control study using EMG-SSR and fNIRS.

Autonomic dysfunction is a well-recognized complication associated with post-COVID-19 syndrome (PCS),. ANS maladaptation could underlie a potential pathogenetic mechanism of PCS, contributing to PCS symptoms. However, there remains an ongoing debate regarding whether autonomic and neuropathic symptoms observed in PCS patients are indicative of central or peripheral ANS pathology. The purpose of this study is to investigate both the central and peripheral nervous systems of ANS in patients with PCS. We evaluated the integrity of the peripheral ANS using sympathetic skin response (SSR) and examined the central ANS using functional near-infrared spectroscopy (fNIRS) covering the fronto-parietal cortex in PCS patients (n=7) and matched healthy controls (n=7). Functional connectivity, topological parameters of fNIRS brain network were analyzed. To compare the SSR and fNIRS parameters between patients and age-matched healthy controls, Mann-Whitney U tests were performed for each parameter separately. The AUC of each topological metric of fNIRS network was utilized as a statistical scalar for comparison. To characterize the correlation between SSR and significantly different topological metrics of fNIRS network, Spearman correlation analysis was performed. The latencies of palmar SSR were significantly prolonged in the patients with PCS than the controls (p<0.05). 46 functional connections showed a significant increase (p<0.05, uncorrected). Regional nodal properties revealed that the fronto-parietal networks of PCS patients had a higher degree in primary somatosensory cortex (S1) (p<0.001, corrected) and motor cortex, a lower node efficiency in dorsolateral prefrontal cortex (DLPFC), and a higher efficiency in S1 (p<0.05, uncorrected). Latencies of palmar SSR were significantly positively correlated with zFC within sensorimotor cortex, and node efficiency/degree of S1 (p<0.01). Amplitudes of palmar and plantar SSR were significantly positively correlated with node efficiency of DLPFC (p<0.05). Our findings suggest that there were alternations in both central and peripheral parts of ANS in PCS patients. These preliminary results indicate that PCS may lead to changes in both the peripheral and central aspects of ANS, which would help to extend the understanding of the role of the ANS in PCS, offering new perspectives on evaluation and treatment. This study has been registered with the Chinese Clinical Trial Registration Center (registration number: ChiCTR2200064342; registration date:2022/10/3).

Comparisons of efficacy and safety of 400 or 800 ml bacterial count fecal microbiota transplantation in the treatment of recurrent hepatic encephalopathy: a multicenter prospective randomized controlled trial in China

BackgroundHepatic encephalopathy (HE) represents a critical complications of end-stage liver disease, serving as an independent predictor of mortality among patients with cirrhosis. Despite effective treatment with rifaximin, some patients with HE still progress to recurrent episodes, posing a significant therapeutic challenge. Recurrent HE is defined as experiencing two or more episodes within a 6-month period. Previous research has suggested that FMT may emerge as a promising treatment for recurrent HE. However, there remains a critical need to explore the optimal dosage. This trial aims to abscess the efficacy and safety of two FMT dosages: 800 ml or 400 ml total bacterial count, including mortality and quality of life.MethodsThis multicenter, prospective, randomized controlled trial will enroll 100 eligible patients from 31 hospitals in China. Participants will be randomly assigned in a 1:1 ratio to either the high-dose group (800 ml total bacterial count) or the low-dose group (400 ml total bacterial count). The primary objective is to assess the efficacy and safety of both dosages on outcomes at 24 and 48 weeks, including mortality and quality of life.DiscussionIf either or both dosages of FMT demonstrate safe and effective treatment of recurrent HE, leading to improve quality of life and survival at 24 and 48 weeks, this trial would address a significant gap in the management of recurrent HE, carrying innovative and clinically significant implications.Trial registrationNCT05669651 on ClinicalTrials.gov. Registered on 29 December 2022. CHiCTR2200067135 on China Registered Clinical Trial Registration Center. Registered on 27 December 2022.

Effect of combined treatment with transcranial direct current stimulation and repetitive transcranial magnetic stimulation compared to monotherapy for the treatment of chronic insomnia: a randomised, double-blind, parallel-group, controlled trial

BackgroundChronic insomnia increases the risk of various health problems and mental illness. Existing research suggests promise for both transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) in treating chronic insomnia individually. However, the combined effects of tDCS and rTMS on this condition remain unclear. This study aimed to verify the efficacy and safety of tDCS combined with rTMS for the treatment of adult patients with chronic insomnia.MethodsThis was a randomised double-blind parallel-group controlled study. Overall, 157 participants with chronic insomnia were randomly assigned to one of three neurotherapy regimens: tDCS + rTMS, sham tDCS + rTMS, or tDCS + sham rTMS. All groups received 20 treatment sessions over 4 consecutive weeks. The primary outcome was the change in patients’ sleep as assessed by the Pittsburgh Sleep Quality Index (PSQI) at 2 weeks, 4 weeks, and 3 months of follow-up. The secondary outcome was the assessment of different dimensions of depression and anxiety in patients through the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA), as well as the occurrence of adverse events.ResultsThroughout the intervention and after the 3-month follow-up, the tDCS + rTMS group had significantly reduced total PSQI scores compared with the other two groups [tDCS + rTMS, 9.21 vs. sham tDCS + rTMS, 10.03; difference − 1.10; 95% confidence interval (CI), − 1.82 to − 0.38; p = 0.003; tDCS + rTMS, 9.21 vs. tDCS + sham rTMS, 10.76; difference − 2.14; 95% CI, − 2.90 to − 1.38; p < 0.001; sham tDCS + rTMS, 10.03 vs. tDCS + sham rTMS, 10.76; difference − 1.04; 95% CI, − 1.82 to − 0.26; p = 0.010), indicating improved overall sleep quality. Total HAMD and insomnia factor scores were significantly lower in the tDCS + rTMS group than in the other two groups after treatment (p < 0.05). Notably, no adverse events or serious adverse reactions were observed during the study period.ConclusionsCombining tDCS with rTMS effectively relieved insomnia symptoms, achieving a significant therapeutic effect after 2-week of intervention, and demonstrating the persistence of treatment effects in later follow-up, emphasising the advantages of combination therapy in improving treatment stability and long-term benefits, reflecting the rapid and effective augmentation of combination therapy. This combined therapy may serve as a safe and effective treatment for adults with chronic insomnia.Trial registrationThis study was registered as a clinical trial with the China Clinical Trial Registration Center (ChiCTR2100052681).

Lacticaseibacillus rhamnosus LRa05 in the treatment of acute diarrhea in children: a randomized controlled trial.

The goal of this study is to assess the efficacy and safety of Lacticaseibacillus rhamnosus LRa05, as an adjunct to the treatment of acute watery diarrhea in children. Eligible diarrheal children were randomized into intervention group (IG, n = 57) and control group (CG, n = 54), and given probiotics or placebo, respectively. The total duration of diarrhea in the IG (121.4 ± 13.7 h) was significantly shorter than that in the CG (143.9 ± 19.8 h, p < 0.001). More children in the IG showed improvements in diarrhea than those in the CG for both per protocol analysis (70.2 vs. 46.3%, p = 0.01) and intention-to-treat analysis (66.7 vs. 41.7%, p = 0.003). The LL-37 levels in the IG was markedly higher than that in the CG after the intervention (4349.35 ± 1143.86 pg./g vs. 3682.49 ± 869.21 pg./g, p = 0.039). The intervention led to higher abundance of Bifidobacterium longum and lower abundance of Enterococcus faecium, Lactobacillus rhamnosus, and Bacteroides fragilis (p < 0.05). LRa05 treatment upregulated the functional genes of gut microbiota involving immunity regulation. Administration of the Lacticaseibacillus rhamnosus LRa05 at a dose of 5 × 109 CFU/day to children aged 0-3 years resulted in shorter duration of diarrhea, faster improvement in fecal consistency, and beneficial changes in gut microbiome composition and gene functions. The present study has been approved and registered in the Chinese Clinical Trial Registration Center with the registration number of ChiCTR2100053700 (https://www.chictr.org.cn/showproj.html?proj=141082).

Effects of dexamethasone combined with vitamin B12 on percutaneous endoscopic interlaminar discectomy early outcomes: a randomized controlled trial

BackgroundResidual low back and leg pain can occur after percutaneous endoscopic interlaminar discectomy (PEID) and compromise early surgical outcomes. This study aimed to determine the efficacy of combining dexamethasone with vitamin B12 (VB12) via epidural injection in improving the symptoms of low back and leg pain after PEID, and the underlying mechanism of action.MethodsPatients who underwent PEID for lumbar disc herniation (LDH) were enrolled and randomly assigned to the single surgery (SS) group, where disc removal was performed via PEID alone, or the combined treatment (CT) group, which received epidural injections of dexamethasone and VB12 alongside surgery. The outcome measures were the Visual Analog Scale (VAS), Japanese Orthopaedic Association (JOA) score, Oswestry Disability Index (ODI), serum inflammatory factor expression, adverse surgical events, duration of postoperative hospitalization, and modified MacNab criteria.ResultsCompared with the SS group, the CT group exhibited lower VAS scores for low back and leg pain at 1, 3, and 7 days post-surgery (P < 0.05). JOA and ODI scores were significantly improved in the CT group than in the SS group 7 days post-surgery (P < 0.05); however, no significant differences were observed at other time points. Serum inflammatory factors were lower in the CT group than in the SS group 3 days post-surgery (P < 0.05). The duration of postoperative hospitalization was shorter in the CT group (P < 0.05). Both groups had similar good outcomes (89.3% vs. 92.2%, P = 0.945).ConclusionsEpidural injection of dexamethasone and VB12 effectively reduces early postoperative low back and leg pain, lowers postoperative inflammatory factor expression, and improves early PEID outcomes. Its clinical adoption merits consideration.Trial registrationThis trial was registered with the China Clinical Trial Registration Center (Identifier: ChiCTR2400088854).

Impact of the coronavirus pandemic on the diagnosis and treatment of head and neck cancer

After the first appearance of COVID-19cases, the virus spread worldwide within afew months. This led to adecrease in medical consultations. The present study investigates whether this effect had an impact on the diagnosis and treatment of head and neck cancer during the period from 2018 to 2022. Data from the clinical cancer registration center (KKR) of Mecklenburg-Vorpommern from the 2020-2022 period were compared to those from the two previous years (2018, 2019). Demographic data, case numbers, diagnosis data, International Classification of Diseases (ICD) codes, and TNM classifications were recorded. COVID-19case numbers were obtained from the Robert Koch Institute (RKI). Data were analyzed using the Mann-Whitney Utest and Pearson's correlation. Atotal of 2332 patient cases could be included in this study. During the lockdown there was neither asignificant reduction in tumor diagnoses registered at the KKR nor acorrelation between COVID-19case numbers and tumor diagnoses. Significant differences were found in terms of Tcategory in the year 2022 compared to the pre-COVID years 2018 and 2019. Furthermore, there was ashift in the relative frequencies of some ICD-10codes. During the COVID-19 pandemic, no significant differences in tumor diagnoses were observed upon comparing the years 2018 to 2022. Contrary to the expectation of adecrease in case numbers during the pandemic due to the lockdown with an increase in tumor stages, areduction of the Tcategory could be found in 2022, and ashift in the relative frequencies of some ICD-10codes in the pandemic period was observed.

Risk Evaluation of Musculoskeletal Disorders (MSDs) at the Outpatient Registration Centre: A Review of Work Postures with the Rapid Office Strain Assessment (ROSA) Method

Risk Evaluation of Musculoskeletal Disorders (MSDs) at the Outpatient Registration Centre: A Review of Work Postures with the Rapid Office Strain Assessment (ROSA) Method

The impact of a continuous care model utilizing a smartphone application on quality of life and anxiety levels among gynecologic cancer patients: a randomized controlled trial

BackgroundPatients diagnosed with gynecological cancers often face a range of complications that can impact their quality of life and increase their anxiety. Nursing models combined with mobile phone applications have the potential to improve outcomes for these patients. This study aimed to assess the impact of a continuous care model utilizing a smartphone application on quality of life and anxiety levels among gynecologic cancer patients.MethodsThis study involved two phases: (1) mobile App development and (2) implementation of the intervention. The two-group randomized controlled trial included 70 participants with gynecological cancers referred to medical centers affiliated with Shahrekord University of Medical Sciences in 2023. The participants were randomized into control or intervention groups (n = 35 per group). Finally, 68 patients completed the trial. The intervention group received an 8-week intervention incorporating the continuous care model, whereas the control group received routine care (the standard support provided by nurses both during and after hospitalization). The participants completed the Spielberger state-trait anxiety and quality of life (QLQ-C30) questionnaires before, immediately after, and two months after the intervention. The data were analyzed via the chi-square test, independent samples t test, analysis of covariance, and repeated-measures ANOVA.ResultsThere were no significant differences in the baseline data between the two groups. However, after the intervention, the intervention group reported a significant increase in quality of life, with mean scores rising from 68.90 ± 17.50 to 73.78 ± 16.79 immediately after the intervention and to 80.61 ± 9.90 at the two-month follow-up. In contrast, the control group showed no significant improvement. Additionally, state anxiety significantly decreased in the intervention group from 51.64 ± 14.97 to 40.20 ± 11.70 at the follow-up, and trait anxiety scores in the intervention group decreased significantly from 49.91 ± 14.96 to 39.82 ± 10.28 at the follow-up, whereas the scores of the control group worsened.ConclusionThe intervention improved quality of life and reduced anxiety in patients with gynecological cancers. Given the scant attention given to mobile application-based follow-up in gynecologic cancer patients in previous studies, this approach can be incorporated into routine care to support patients, and it is recommended for nurses, health care providers, and physicians.Trial registrationThe study was registered as a randomized controlled trial in the Clinical Trial Registration Center of Iran. Registration Date: 2024-02-14, Registration Number: IRCT20231107059977N1.

A Systematic Review and Meta-Analysis of the Diagnostic Accuracy of Endometrial Sampling Tests for Detecting Endometrial Cancer

Abstract Objectives to determine the diagnostic accuracy of different endometrial sampling tests for detecting endometrial carcinoma. Design a systematic review and meta-analysis of studies of diagnostic accuracy. Eligibility Criteria We included published diagnostic test accuracy studies of women, of all ages, who had an endometrial sampling for preoperatively detecting endometrial cancer with verification using histopathology of hysterectomy specimens as the reference standard. We excluded case control and case series studies. Information Sources We searched the Cochrane library, MEDLINE/PubMed, CINAHL, Web of Science, and Scopus from the date of inception of the databases to January 18, 2023. We did not apply any restrictions on language or date of publication. We searched the references of included studies and other systematic reviews. Risk of Bias We extracted study data and assessed study quality using the revised quality assessment tool for diagnostic accuracy studies (QUADAS-2). Synthesis of Results We used bivariate diagnostic random-effects meta-analysis and presented the results in a summary receiver operating characteristic curve. We assessed the certainty of evidence as recommended by the GRADE approach. Results Twelve included studies, published between 1986 and 2022, recruited 1607 participants. Seven studies were low risk of bias in all domains and all studies had low applicability concerns. The most examined index tests were Pipelle and conventional dilation and curettage. For diagnosing endometrial carcinoma, the sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio (95% confidence intervals), for Pipelle were 0.774 (0.565, 0.900), 0.985 (0.927, 0.997), 97.000 (14.000, 349.000), and 0.241 (0.101, 0.442) and for conventional dilation and curettage were 0.773 (0.333, 0.959), 0.987 (0.967, 0.995), 62.300 (18.600, 148.000), and 0.268 (0.042, 0.676); respectively. Conclusion High certainty evidence indicates that pre-operative endometrial sampling particularly using Pipelle or conventional curettage is accurate in diagnosing endometrial cancer. Studies assessing other endometrial sampling tests were sparse. Systematic review Registration Center for Open Science, osf.io/h8e9z

Development and application of an artificial intelligence-assisted endoscopy system for diagnosis of Helicobacter pylori infection: a multicenter randomized controlled study

BackgroundThe early diagnosis and treatment of Heliobacter pylori (H.pylori) gastrointestinal infection provide significant benefits to patients. We constructed a convolutional neural network (CNN) model based on an endoscopic system to diagnose H. pylori infection, and then examined the potential benefit of this model to endoscopists in their diagnosis of H. pylori infection.Materials and methodsA CNN neural network system for endoscopic diagnosis of H.pylori infection was established by collecting 7377 endoscopic images from 639 patients. The accuracy, sensitivity, and specificity were determined. Then, a randomized controlled study was used to compare the accuracy of diagnosis of H. pylori infection by endoscopists who were assisted or unassisted by this CNN model.ResultsThe deep CNN model for diagnosis of H. pylori infection had an accuracy of 89.6%, a sensitivity of 90.9%, and a specificity of 88.9%. Relative to the group of endoscopists unassisted by AI, the AI-assisted group had better accuracy (92.8% [194/209; 95%CI: 89.3%, 96.4%] vs. 75.6% [158/209; 95%CI: 69.7%, 81.5%]), sensitivity (91.8% [67/73; 95%CI: 85.3%, 98.2%] vs. 78.6% [44/56; 95%CI: 67.5%, 89.7%]), and specificity (93.4% [127/136; 95%CI: 89.2%, 97.6%] vs. 74.5% [114/153; 95%CI: 67.5%, 81.5%]). All of these differences were statistically significant (P < 0.05).ConclusionOur AI-assisted system for diagnosis of H. pylori infection has significant ability for diagnostic, and can improve the accuracy of endoscopists in gastroscopic diagnosis.Trial registrationThis study was approved by the Ethics Committee of Daping Hospital (10/07/2020) (No.89,2020) and was registered with the Chinese Clinical Trial Registration Center (02/09/2020) (www.chictr.org.cn; registration number: ChiCTR2000037801).

A study on improving cancer-related fatigue and disease-related psychological variables in patients with cervical cancer based on online mindfulness-based stress reduction: a randomized controlled trial

BackgroundThe persistent destructive power of cancer-related fatigue (CRF) has been regarded as the biggest influencing factor affecting the postoperative physical and mental health of patients with cervical cancer. During this process, patients might also experience different feelings of disease-related psychological. Therefore, this study aimed to adopt mindfulness-based stress reduction (MBSR) to intervene in patients with cervical cancer, and conducted follow-up for 3 and 6 months to observe the effects of changes in CRF, uncertainty in illness, coping styles, sense of coherence (SOC), and perceived social support (PSS).MethodsA randomized controlled trial was conducted in ShengJing Hospital of China Medical University. A total of 102 patients were selected, and 78 patients completed the whole process, including 40 in the experimental group and 38 in the control group. Data were collected according to Cancer Fatigue Scale, Medical Coping Modes Questionnaire, Multidimensional Scale of Perceived Social Support, and Sense of Coherence-13. The change trend and difference of the two groups of research data were compared by repeated measurement analysis of variance. Bonferroni test was used for multiple tests between groups.ResultsThe CRF, SOC, and coping styles of the MBSR group showed a decreasing trend (P < 0.001) at after MBSR, 3 months follow-up, and 6 months follow-up compared to the before MBSR. However, the uncertainty in illness of the MBSR group showed a decreasing trend (P < 0.001) at after MBSR compared to the before MBSR, and it rose in 3 months follow-up and 6 months follow-up.ConclusionMBSR can effectively alleviate the fatigue of CRF after treatment, while improving their psychological environment. Medical workers can consider implementing online MBSR for patients with cervical cancer in their daily rehabilitation nursing, which is beneficial for their recovery.Trial registrationChina Clinical Trial Registration Center ChiCTR2000040122 (https//www.chictr.org.cn/). Registered on November 21, 2020.

Safety and efficacy of traditional Chinese manual therapy for cervicogenic dizziness: study protocol for a randomized, controlled, multicenter trial

BackgroundCervicogenic dizziness is a clinical syndrome characterized by neck pain and dizziness, which has a rising incidence in recent years. In China, manual therapy has been widely used in the treatment of cervicogenic dizziness, but there is no high-quality medical evidence to support its effectiveness and safety. The purpose of this study was to assess the safety and efficacy of Shi's manual therapy (SMT) on the treatment of cervicogenic dizziness. MethodsA multicenter randomized controlled trial (RCT) will perform on 106 patients (18≤ages≤65) who meet the diagnostic criteria of cervicogenic dizziness. Patients will be randomly allocated to the intervention group and the control group at a ratio of 1:1. Participants in the control group will be treated with Merislon (Betahistine Mesilate Tablets). Participants in the intervention group will be treated with SMT. The primary outcome is the response rate at week 2, which is defined as the proportion of patients who reduce their disability level measured by the Dizziness Handicap Inventory (DHI) score relative to baseline. Key secondary outcomes include DHI scores at weeks 1, 2, and 6 and changes from baseline, time to disappearance of dizziness symptoms, and recurrence rate of dizziness symptoms. Safety will be assessed by adverse events, physical examination and vital signs. DiscussionThis trial aims to provide high-quality evidence-based medical data to demonstrate that SMT can reduce dizziness in patients with cervicogenic dizziness effectively and safely. Trial registrationClinical Trial Registration Center NCT05604937. Registered on Nov 3, 2022. Protocol version1.0, November 20, 2022.

Unraveling Changes of Brachial Artery Residual Stress and Its Relationship to Cardiovascular Disease Risk Factors.

Arterial pressure volume index (API) offers a non-invasive measurement of brachial artery residual stress. This study investigated API distribution characteristics and correlations with cardiovascular disease risk (CVD) factors in a large Chinese population sample. This cross-sectional study surveyed a total of 7620 participants. We analyzed the relationships between API and factors influencing CVD, using regression-based stepwise backward selection and restrictive cubic spline models to express relationships as standardized beta values. Multiple linear regression analysis identified many independent factors influencing API including age, sex, body mass index (BMI), pulse pressure (PP), heart rate (HR), hemoglobin, uric acid (UA), estimated glomerular filtration rate (eGFR), triglyceride (TC), and a history of hypertension. Notably, API values increased at 33 and escalated with advancing age. Increases in API were associated with rises in PP and UA increases, particularly when PP reached 60 mmHg and the UA reached 525 units. Conversely, API was found to decrease with elevated HR and eGFR. Furthermore, there was a significant inverted U-shaped relationship between API and BMI. This study was the first to describe API distribution characteristics in a large sample of the Chinese population, providing references for evaluating API changes in the assessment of residual stress variations in diverse diseases. Notably, API displayed a U-shaped relationship with age and was closely related to traditional CVD risk factors, underscoring its potential as a non-invasive tool for risk assessment in vascular health. This research was registered with the China Clinical Trial Registration Center (Registration Number: ChiCTR2000035937).

APPS: Authentication-enabled privacy protection scheme for secure data transfer in Internet of Things

The Internet of Things (IoT) is an emerging field that encompasses several heterogeneous devices and smart objects that are integrated with the network. In open platforms, these objects are deployed to present advanced services in numerous applications. Innumerable security-sensitive data is generated by the IoT device and therefore, the security of these devices is an important task. This work formulates a secure data transfer technique in IoT, named Authentication enabled Privacy Protection (APPS) scheme for resource-constrained IoT devices. The proposed scheme demonstrates resilience against various attacks; such as resisting reply attacks, device anonymity, untracebility, session key establishment, quantum attacks and resisting MITM attacks. For the privacy protection scheme, the secured data transfer is initiated between the entities, like IoT devices, servers, and registration centers, by using various phases, namely registration phase, key generation phase, data encryption, authentication, verification, and data retrieval phase. Here, a mathematical model is designed for protecting data privacy using hashing, encryption, secret keys, etc. Finally, performance of proposed APPS model is analyzed; wherein the outcomes reveal that the proposed APPS model attained the maximum detection rate of 0.85, minimal memory usage of 0.497MB, and minimal computational time of 112. 79 sec and minimal turnaround time 131.91 sec.

Orofacial clefts in Costa Rica, 1996-2021: Analysis of surveillance data.

Orofacial clefts (OFCs) are among the most common birth defects (BD). In 2008, a series of improvements began in the Costa Rican Birth Defect Register Center (CREC). We aim to explore trends between 1996 and 2021. A trend analysis of OFCs from 1996 to 2021 and a descriptive analysis of OFCs from 2010 to 2021 were performed based on data from the CREC, the national BD surveillance system. Prevalence at birth was calculated according to the type: cleft palate (CP), cleft lip with or without CP (CL ± P), and presentation (isolated, multiple non-syndromic, or syndromes). We used joinpoint regression to identify if a significant change in trend occurred; the average annual percent change (AAPC) was determined. Marginal means and prevalence ratios by subperiod (1996-2009 as referent and 2010-2021) were estimated using Poisson regression and compared using Wald's chi-square tests (α ≤.05). We found a significant AAPC for OFCs prevalence of +1.4: +0.6 for isolated, +2.9 for multiple non-syndromic, and +7.7 for syndromes (p < .05). When comparing the OFC's prevalence of the subperiod 2010-2021 (11.86 per 10,000) with 1996-2009 (9.36 per 10,000) the prevalence ratio was 1.3 (p < .01): 1.1 (p < .05) for isolated, 1.6 (p < .01) for multiple non-syndromic, and 3.3 (p < .01) for syndromes. The prevalence of OFCs from 2010 to 2021 was 9.1 for CL ± P and 2.8 for CP. Seventy-one percent of the OFCs were isolated, 22% multiple non-syndromic, and 7% syndromes. The trend in OFCs' prevalence is toward increasing, mainly due to improvements in the surveillance system.