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Chen Z, Li M, Wu Z, Zhang M, Weng G, Li M, Liao R, Zhao P, Wu J, Zhu S, Wang Q, Li C, Wei X. Cerebral Circulation Time Is a Potential Predictor of Disabling Ischemic Cerebrovascular Events in Patients With Non-disabling Middle Cerebral Artery Stenosis. Front Neurol 2021; 12:653752. [PMID: 34025557 PMCID: PMC8137834 DOI: 10.3389/fneur.2021.653752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Abstract
Patients with non-disabling middle cerebral artery (MCA) stenosis (ND-MCAS) are at risk for disabling ischemic cerebrovascular events (DICE) despite aggressive medical therapy. In this study, we aimed to verify whether cerebral circulation time (CCT) was a potential predictor of DICE in patients with ND-MCAS. From January 2015 to January 2020, 46 patients with ND-MCAS treated with aggressive medical therapy were enrolled for digital subtraction angiography (DSA) in this convenience sampling study. They were divided into the DICE (-) and DICE (+) groups based on the occurrence of DICE within 3 months after DSA. The CCT was defined as the time from the appearance of the MCA to the peak intensity of the Trolard vein during DSA. The rCCT (relative CCT) was defined as the ratio of the CCT of the stenotic side (sCCT) to the CCT of the healthy side (hCCT). The differences in sCCT, hCCT, and rCCT between the two groups were analyzed with Mann-Whitney U tests. Logistic regression analysis was performed to evaluate the association between the risk factors and DICE. Receiver operating characteristic (ROC) curves were constructed to assess the predictive value of rCCT in identifying DICE in ND-MCAS patients. The results showed that DICE appeared in 5 of the 46 patients within 3 months. rCCT were significantly increased in the DICE (+) group compared with the DICE (-) group [1.08 (1.05, 1.14) vs. 1.30 (1.22, 1.54), p < 0.001]. Logistic regression analysis found that prolonged rCCT was an independent positive prognostic factor for DICE (odds ratio = 1.273, p = 0.019) after adjustment for potential confounders (age, diabetes, antithrombotic use, and stenosis degree). ROC analysis showed that rCCT provided satisfactory accuracy in distinguishing the DICE (+) group from the DICE (-) group among ND-MCAS patients (area under the curve = 0.985, p < 0.001), with an optimal cutoff point of 1.20 (100% sensitivity, 97.6% specificity). In conclusion, prolonged rCCT is independently associated with the occurrence of DICE in ND-MCAS patients and may be used to identify individuals at risk of DICE.
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Zhang G, Yan G, Liu Y, Zhu S, Wang X. 050 Loss of retinoic acid receptor-related receptor alpha (Rorα) promotes the progression of UV-induced cSCC. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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78
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Zhao H, Tan Z, He L, Zhu S, Yan R, Kou H, Peng J. [Amiodarone promotes heat-induced apoptosis, inflammation and oxidative stress in mouse HL1 atrial myocytes]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:406-411. [PMID: 33849832 DOI: 10.12122/j.issn.1673-4254.2021.03.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the injury types of atrial myocytes induced by heat exposure and the effect of amiodarone on heat-induced injuries in atrial myocytes. OBJECTIVE The optimal temperature for heat exposure and optimal concentration of amiodarone were determined by measuring the cell viability exposed to different temperatures and different concentrations of amiodarone. Heat exposure of HL1 atrial myocytes was conducted using a water bath, and the effect of amiodarone on cell viability was assessed with MTS method; cell apoptosis was detected using flow cytometry, and the levels of IL-1β, IL-6, TNF-α, SOD and MDA were detected with enzyme-linked immunosorbent assay (ELISA). OBJECTIVE Compared with the blank control cells, the cells exposed to a temperature of 52 ℃ showed a significantly decreased survival rate and a lowered SOD activity (P < 0.001) with increased IL-1β and MDA levels (P < 0.01) and markedly increased apoptosis rate and IL-6 level (P < 0.001). Compared with the heat exposure group, amiodarone resulted in significantly decreased survival rate of the atrial myocytes (P < 0.01), obviously decreased SOD activity (P < 0.05), and increased cell apoptosis rate (P < 0.05) and IL-1β, IL-6, MDA and TNF-α levels (P < 0.01 or 0.001). OBJECTIVE Heat exposure induces apoptosis, inflammation and oxidative stress in mouse HL1 atrial myocytes, and amiodarone can enhance the effects of heat exposure to aggravate the cell injuries.
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Zhang B, Liu W, Ren D, Li F, Wang Y, Huo D, Zhu S, Chen J, Song Q, Xu S. 62MO Comparison of lobectomy and sublobar resection for stage IA elderly NSCLC patients (≥70 years): A population-based propensity score matching study. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01904-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zhu S, Yang C, Li J, Mei W. 121 Mediating Factors Between Caregiver Burden and Quality of Life in Caregivers of Older Patients with Newly Diagnosed Lung Cancer. Age Ageing 2021. [DOI: 10.1093/ageing/afab030.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Family caregivers of older patients with newly diagnosed lung cancer become responsible for patients’ care, usually without preparation or training in provision of care. Their efforts of care generate caregiving burden, which could deteriorate their quality of life and affect the prognosis of patients. The aims of this study were to examine associations between caregiver burden and quality of life, coping, social support for family caregivers, and to investigate whether coping and social support mediate associations between family caregiver burden and their quality of life.
Methods
A cross-sectional study was performed at two thoracic surgery wards in one tertiary hospital in Changsha, China from November 2019 to May 2020. This study involved 224 family caregivers of patients aged over 50 years and newly diagnosed with lung cancer. Caregivers-reported outcomes were measured by Zarit caregiver burden interview, simplified coping style questionnaire, social support rating scale, and quality of life family version. Structural equation modeling (SEM) was used to test the hypothesized mediation model.
Results
SEM indicated a good fit for the mediation model, which explained 49.7% of the variance of quality of life. Higher level of caregivers’ burden was negatively associated with quality of life (r = 0.183, P = 0.042). Coping partially mediated the effect of caregiver burden on quality of life (indirect effect −0.389, P = 0.000). Social support did not mediate the relationship between caregiver burden and quality of life (indirect effect −0.023, P = 0.087).
Conclusions
Caregivers’ burden of patients with newly diagnosed lung cancer is correlated to quality of life which is partially mediated by coping. Early intervention providing caregivers with positive coping strategies may improve their quality of life.
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Yang C, Hui Z, Zhu S, Wang X, Tang G, Lee DTF. 83 A Medication Self-Management Intervention to Improve Medication Adherence For Older People with Multimorbidity: A Pilot Study. Age Ageing 2021. [DOI: 10.1093/ageing/afab030.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Medication self-management support has been recognised as an essential element in primary health care to promote medication adherence and health outcomes for older people with chronic conditions. A patient-centred intervention empowering patients and supporting medication self-management activities could benefit older people. This pilot study tested a newly developed medication self-management intervention for improving medication adherence among older people with multimorbidity.
Method
This was a two-arm randomised controlled trial. Older people with multimorbidity were recruited from a community healthcare centre in Changsha, China. Participants were randomly allocated to either a control group receiving usual care (n = 14), or to an intervention group receiving three face-to-face medication self-management sessions and two follow-up phone calls over six weeks, targeting behavioural determinants of adherence from the Information-Motivation-Behavioural skills model (n = 14). Feasibility was assessed through recruitment and retention rates, outcome measures collection, and intervention implementation. Follow-up data were measured at six weeks after baseline using patient-reported outcomes including medication adherence, medication self-management capabilities, treatment experiences, and quality of life. Preliminary effectiveness of the intervention was explored using generalised estimating equations.
Results
Of the 72 approached participants, 28 (38.89%) were eligible for study participation. In the intervention group, 13 participants (92.86%) completed follow-up and 10 (71.42%) completed all intervention sessions. Ten participants (71.42%) in the control group completed follow-up. The intervention was found to be acceptable by participants and the intervention nurse. Comparing with the control group, participants in the intervention group showed significant improvements in medication adherence (β = 0.26, 95%CI 0.12, 0.40, P < 0.001), medication knowledge (β = 4.43, 95%CI 1.11, 7.75, P = 0.009), and perceived necessity of medications (β = −2.84, 95%CI -5.67, −0.01, P = 0.049) at follow-up.
Conclusions
The nurse-led medication self-management intervention is feasible and acceptable among older people with multimorbidity. Preliminary results showed that the intervention may improve patients’ medication knowledge and beliefs and thus lead to improved adherence.
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Ibrahim K, Lim T, Mullee MA, Yao GL, Zhu S, Baxter M, Tilley S, Russel C, Roberts HC. 20 Comparison of Six Frailty Screening Tools in Patients Aged 65+ with An Arm Fragility Fracture. Age Ageing 2021. [DOI: 10.1093/ageing/afab028.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Frailty is associated with an increased risk of falling and fracture, but not routinely assessed in fracture clinic. Early identification and management of frailty among older people with arm fragility fracture could help avoid further falls and fractures, especially of the hip. We evaluated the feasibility of assessing frailty in a busy fracture clinic.
Methods
People aged 65+ years with an arm fracture in one acute trust were recruited. Frailty was assessed in fracture clinics using six tools: Fried Frailty Phenotype (FFP), FRAIL scale, PRISMA-7, electronic Frailty Index (e-FI), Clinical Frailty Score (CFS), and Study of Osteoporotic Fracture (SOF). The sensitivity and specificity of each tool was compared against FFP as a reference. Participants identified as frail by 2+ tools were referred for Comprehensive Geriatric Assessment (CGA).
Results
100 patients (mean age 75 years±7.2; 20 men) were recruited. Frailty prevalence was 9% (FRAIL scale), 13% (SOF), 14% (CFS > 6), 15% (FFP; e-FI > 0.25), and 25% (PRISMA-7). Men were more likely to be frail than women. Data were complete for all assessments and completion time ranged from one minute (PRISMA-7; CFS) to six minutes for the FFP which required most equipment. Comparing with FFP, the most accurate instrument for stratifying frail from non-frail was the PRISMA-7 (sensitivity = 93%, specificity = 87%) while the remaining tools had good specificity (range 93%–100%) but average sensitivity (range 40%–60%). Twenty patients were eligible for CGA. Five had recently had CGA and 11/15 referred were assessed. CGA led to 3–6 interventions per participant including medication changes, life-style advice, investigations, and onward referrals.
Conclusion
It was feasible to assess frailty in fracture clinic and to identify patients who benefitted from CGA. Frailty prevalence was 9%—25% depending on the tool used and was higher among men. PRISMA-7 could be a practical tool for routine use in fracture clinics.
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83
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Ibrahim K, Mullee MA, Yao GL, Zhu S, Baxter M, Tilley S, Russel C, Roberts HC. 154 The Feasibility of Assessing Sarcopenia Among Older People with Arm Fracture Using Different Criteria. Age Ageing 2021. [DOI: 10.1093/ageing/afab030.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Osteoporosis and sarcopenia often co-exist (osteo-sarcopenia) and both are associated with increased risk of falls and fractures. Early identification and treatment of sarcopenia among older people with fragility arm fractures could prevent further fractures. This study evaluated the feasibility of assessing sarcopenia in a fracture clinic.
Methods
People aged 65+ years with arm fracture attending fracture clinics in one acute trust were recruited. Sarcopenia was assessed using gait speed, grip strength with unfractured arm (hand dynamometer using appropriate cut off adjusted for age and gender), skeletal muscle mass index SMI (Bioimpedance BIA), SARC-F questionnaire, the European Working Group on Sarcopenia in Older People (EWGSOP) I and II criteria. The sensitivity and specificity of each measure was calculated against the EWGSOP II criteria as the standard reference.
Results
100 patients (Mean age 75 years±7.2; 80 female) were recruited. Sarcopenia was identified among 4% (EWGSOP I), 5% (SMI), 13% (EWGSOP II), 16% (gait speed test), 18% (SARC-F) and 39% (grip strength) and was more prevalent among men. SARC-F had the best sensitivity and specificity (100% and 96% respectively) when compared to the EWGSOP II criteria. Sensitivity and specificity for the remaining measures were respectively (100%, 71%) for grip strength, (75%, 94%) for gait speed, (25%, 97%) with SMI and (25%, 99%) for EWGSOP I. Time needed to complete the assessments was 1–2 minutes for gait speed, grip strength and SARC-F; five minutes for BIA test, and nine minutes when EWGSOP I and II criteria were applied. Data were complete for grip strength and SARC-F. Missing data was reported among 2% for gait speed, 8% for BIA test, 8% for EWGSOP II and 10% for EWGSOP I.
Conclusion
It was feasible to assess sarcopenia in fracture clinics and SARC-F was a quick, simple and sensitive tool suitable for routine use.
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Yang C, Hui Z, Zhu S, Wang X, Tang G, Lee DTF. 122 A Medication Self-Management Intervention to Improve Medication Adherence for Older People with Multimorbidity: A Pilot Trial. Age Ageing 2021. [DOI: 10.1093/ageing/afab030.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Medication self-management support has been recognised as an essential element in primary health care to promote medication adherence and health outcomes for older people with chronic conditions. A patient-centred intervention empowering patients and supporting medication self-management activities could benefit older people. This pilot study tested a newly developed medication self-management intervention for improving medication adherence among older people with multimorbidity.
Method
This was a two-arm randomised controlled trial. Older people with multimorbidity were recruited from a community healthcare centre in Changsha, China. Participants were randomly allocated to either a control group receiving usual care (n = 14), or to an intervention group receiving three face-to-face medication self-management sessions and two follow-up phone calls over six weeks, targeting behavioural determinants of adherence from the Information-Motivation-Behavioural skills model (n = 14). Feasibility was assessed through recruitment and retention rates, outcome measures collection, and intervention implementation. Follow-up data were measured at six weeks after baseline using patient-reported outcomes including medication adherence, medication self-management capabilities, treatment experiences, and quality of life. Preliminary effectiveness of the intervention was explored using generalised estimating equations.
Results
Of the 72 approached participants, 28 (38.89%) were eligible for study participation. In the intervention group, 13 participants (92.86%) completed follow-up and 10 (71.42%) completed all intervention sessions. Ten participants (71.42%) in the control group completed follow-up. The intervention was found to be acceptable by participants and the intervention nurse. Comparing with the control group, participants in the intervention group showed significant improvements in medication adherence (β = 0.26, 95%CI 0.12, 0.40, P < 0.001), medication knowledge (β = 4.43, 95%CI 1.11, 7.75, P = 0.009), and perceived necessity of medications (β = −2.84, 95%CI -5.67, −0.01, P = 0.049) at follow-up.
Conclusions
The nurse-led medication self-management intervention is feasible and acceptable among older people with multimorbidity. Preliminary results showed that the intervention may improve patients’ medication knowledge and beliefs and thus lead to improved adherence.
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85
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Jiang N, Yang Y, Zhang L, Jiang Y, Wang M, Zhu S. 3D-Printed Polycaprolactone Reinforced Hydrogel as an Artificial TMJ Disc. J Dent Res 2021; 100:839-846. [PMID: 33719668 DOI: 10.1177/00220345211000629] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The replacement of a damaged temporomandibular joint (TMJ) disc remains a long-standing challenge in clinical settings. No study has reported a material with comprehensively excellent properties similar to a natural TMJ disc. In this work, we designed a novel artificial TMJ disc using polyvinyl alcohol (PVA) hydrogel crosslinked by cyclic freeze-thaw and reinforced by 3D-printed polycaprolactone (PCL) implants. The mechanical properties and surface morphologies of the artificial TMJ disc and the natural goat TMJ disc were tested and compared via compression, tensile, cyclic compression/tensile, creep, friction, scanning electron microscopy, and atomic force microscopy. The fibroblasts and chondrocytes were cultured on the artificial TMJ disc for 1, 3, and 5 d for cytotoxicity testing. Importantly, the artificial discs were placed into the TMJs of goats in an innovative way to induce disc defect repair for 12 wk. The PVA + PCL artificial disc demonstrated mechanical strength similar to that of natural disc, as well as 1) better fatigue resistance, viscoelasticity, and hydrophilicity; 2) less creep; and 3) low friction, cytotoxicity, and cell adhesion. By repairing the defects of the TMJ disc in goats, the artificial disc demonstrated the ability to maintain joint stability and protect condylar cartilage and bone from damage. These promising results indicate the feasibility of using a PVA + PCL artificial TMJ disc in a clinical context.
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Wang Y, Xu S, Zhao S, Li X, Zhu S, Chen J. P38.11 Clinical and Molecular Characteristics of TSC1/2 Mutant Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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87
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Zhu S, Li X, Zhao S, Wang Y, Xu S. P07.03 The Impact of PD-L1 Expression on the Prognosis of Early-Stage Resected NSCLC: A Meta-Analysis of Literatures. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chen M, Li X, Wan B, Zhu S, Chen C, Zhang F, Song Y, Lv T. P36.08 Effect of Soluble CD39 and PD-L1 Levels on Diagnosis and Prognosis of Lung Cancer Patients with Malignant Pleural Effusion. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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89
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Nelson A, Fiskum G, Renn C, Zhu S, Kottilil S, Klinedinst N. Mechanisms of Musculoskeletal Frailty in People Living with HIV. J Frailty Aging 2021; 11:83-90. [DOI: 10.14283/jfa.2021.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
People over age 50 living with HIV experience frailty including functional declines and illnesses usually attributed to aging, more frequently and ten years earlier than people without HIV. As the number of people living with HIV over age 50 is expected to triple by the year 2040, those experiencing early frailty will continue to grow. This review synthesizes the known correlates and contributors to musculoskeletal frailty in people living with HIV. A conceptual model of musculoskeletal frailty in HIV that outlines chronic inflammation, altered energy metabolism, immune activation, and endocrine alterations as mechanisms associated with frailty development is presented. Additionally, the potential ability of aerobic exercise to modify the risk of frailty is highlighted as an important intervention.
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Ding L, Miao X, Lu J, Hu J, Xu X, Zhu H, Xu Q, Zhu S. Comparing the Performance of Different Instruments for Diagnosing Frailty and Predicting Adverse Outcomes among Elderly Patients with Gastric Cancer. J Nutr Health Aging 2021; 25:1241-1247. [PMID: 34866152 DOI: 10.1007/s12603-021-1701-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To examine the diagnostic performance of the Tilburg Frailty Indicator (TFI), 11-factor modified frailty index (mFI-11), and 5-factor modified frailty index (mFI-5) for frailty defined by Frailty Phenotype (FP), as well as to compare the predictive ability of TFI, mFI-11, and mFI-5 for adverse outcomes in hospital among elderly patients undergoing gastric cancer surgery. DESIGN A prospective cohort study. SETTING Hospitalization setting, Nanjing, China. PARTICIPANTS We recruited 259 elderly patients undergoing gastric cancer surgery from a tertiary hospital. MEASUREMENTS Frailty was assessed by the FP, TFI, mFI-11, and mFI-5 before surgery, respectively. The receiver operating characteristic (ROC) curves were plotted to compared the diagnostic performance of TFI, mFI-11, and mFI-5 using FP as the reference. ROC curves were used to examine the performance of TFI, mFI-11, and mFI-5 in predicting adverse outcomes. The area under the curve (AUC)>0.70 was regarded as an indicator of good performance. RESULTS The prevalence of frailty ranged from 8.5% (mFI-11) to 45.9% (TFI). The AUCs of TFI (AUC: 0.764, p<0.001) was significantly greater than that of mFI-11 (AUC: 0.600, p=0.033) and mFI-5 (AUC: 0.600, p=0.0311) in the detection of frailty defined by FP, with quite different sensitivity and specificity at their original cutoffs. TFI and mFI-11 both had statistically significant but similarly inadequate predictive accuracy for adverse outcomes in hospital, including total complications (AUCs: 0.618; 0.621), PLOS (AUCs: 0.593; 0.639), increased hospital costs (AUCs: 0.594; 0.624), and hypoproteinemia (AUCs: 0.573; 0.600). For the mFI-5, only the predictive ability for hypoproteinemia was statistically significant, with poor accuracy (AUC: 0.592, p<0.0055). CONCLUSION The TFI performed slightly better than mFI-11 and mFI-5 in our study. Moreover, future studies are needed to further determine an optimal frailty instrument with great diagnostic and predictive accuracy.
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Chang Z, Zou H, Xie Z, Deng B, Que R, Huang Z, Weng G, Wu Z, Pan Y, Wang Y, Li M, Xie H, Zhu S, Xiong L, Ct Mok V, Jin K, Yenari MA, Wei X, Wang Q. Cystatin C is a potential predictor of unfavorable outcomes for cerebral ischemia with intravenous tissue plasminogen activator treatment: A multicenter prospective nested case-control study. Eur J Neurol 2020; 28:1265-1274. [PMID: 33277774 DOI: 10.1111/ene.14663] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/12/2020] [Accepted: 11/30/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE The aim of this study was to explore whether cystatin C (CysC) could be used as a potential predictor of clinical outcomes in acute ischemic stroke (AIS) patients treated with intravenous tissue plasminogen activator (IV-tPA). METHODS We performed an observational study including a retrospective analysis of data from 125 AIS patients with intravenous thrombolysis. General linear models were applied to compare CysC levels between groups with different outcomes; logistic regression analysis and receiver-operating characteristic curves were adopted to identify the association between CysC and the therapeutic effects. RESULTS Compared with the "good and sustained benefit" (GSB) outcome group (defined as ≥4-point reduction in National Institutes of Health Stroke Scale or a score of 0-1 at 24 h and 7 days) and the "good functional outcome" (GFO) group (modified Rankin Scale score 0-2 at 90 days), serum CysC baseline levels were increased in the non-GSB and non-GFO groups. Logistic regression analysis found that CysC was an independent negative prognostic factor for GSB (odds ratio [OR] 0.010; p = 0.005) and GFO (OR 0.011; p = 0.021) after adjustment for potential influencing factors. Receiver-operating characteristic curves showed the CysC-involved combined models provided credible efficacy for predicting post-90-day favorable clinical outcome (area under the curve 0.86; p < 0.001). CONCLUSIONS Elevated serum CysC is independently associated with unfavorable clinical outcomes after IV-tPA therapy in AIS. Our findings provide new insights into discovering potential mediators for neuropathological process or treatment in stroke.
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Xing Y, Wang H, Yao XH, Li Y, Huang JT, Tang J, Zhu S, Liu YQ, Xiao J. Analysis of factors for disease progression in 61 patients with COVID-19 in Xiaogan, Hubei, China. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2020; 24:12490-12499. [PMID: 33336768 DOI: 10.26355/eurrev_202012_24045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this study was to retrospectively analyze clinical characteristics and laboratory results of the novel coronavirus pneumonia (COVID-19) patients so as to identify factors related to disease progression. PATIENTS AND METHODS Sixty-one patients with COVID-19 were divided into two groups: an improvement/stabilization group (n = 53) and a progression group (n = 8). Clinical data were collected to analyze and compare the differences between the two groups. RESULTS Of the sixty-one patients, thirty-one were male (50.8%), and thirty were female (49.2%), with a median age of 53 years. On admission, significant differences were observed between the two groups with respect to the levels of Creatine Kinase (CK), lymphocytes, D-dimer and creatinine, and prothrombin time (PT). Univariate logistic regression analysis showed that Platelet-to-lymphocyte ratio (PLR), lymphocytes, Mean platelet volume to lymphocyte ratio (MPVLR), CK, White Blood count to mean platelet volume ratio (WMR), Lymphocyte-to-monocyte ratio (LMR), and serum creatinine were important factors for disease progression. Multivariate logistic regression analysis showed that PLR was an independent factor for disease progression in COVID-19 patients. The receiver operating characteristic (ROC) curve revealed that the best predictor of disease progression was CK. Dynamic changes in the laboratory indicators of patients were tracked, and significant differences were found in the variation trends of white blood cell count, neutrophil count, and WMR, which gradually increased in the progression group, but gradually decreased in the improvement/stabilization group. CONCLUSIONS Risk factors for disease progression included PLR, lymphocytes, MPVLR, CK, WMR, LMR, and creatinine, among which, PLR is an independent risk factor for disease progression in COVID-19 patients.
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Wu D, Zhu S, Memon AA, Memon H. Financial Attributes, Environmental Performance, and Environmental Disclosure in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238796. [PMID: 33256162 PMCID: PMC7730338 DOI: 10.3390/ijerph17238796] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 11/16/2022]
Abstract
Contest between the international or national enterprises stimulates the formation of innovative or improved products or of well-organized processes. Nevertheless, reliance on carbon-based materials and energy emission sources has been highlighted as a primary problem of the 21st century. The current study examines the influence of carbon disclosure information (CDI), media reporting and financial influence on state-owned enterprises (SOEs) and non-state-owned enterprises (NSOEs) by using Shenzhen and Shanghai's heavy polluting listed industries' dataset from 2014 to 2019. By applying different data approaches, the estimated results demonstrate that the CDI level is significantly negative related to SOE compared to NSOE. The estimated results explain that media's positive reporting offsets the additional benefits to stakeholders. While media's negative reporting negatively influences a firm's competitive position, it mitigates the stock price and its social value. Our results suggest that external factors are encouraging for the financial values of stakeholders, along with those of enterprises.
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Zhu S, Li H, Deng B, Zheng J, Huang Z, Chang Z, Huang Y, Wen Z, Liang Y, Yu M, Chan LL, Tan EK, Wang Q. Various Diseases and Clinical Heterogeneity Are Associated With "Hot Cross Bun". Front Aging Neurosci 2020; 12:592212. [PMID: 33328971 PMCID: PMC7714952 DOI: 10.3389/fnagi.2020.592212] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022] Open
Abstract
Objective: To characterize the clinical phenotypes associated with the "hot cross bun" sign (HCBs) on MRI and identify correlations between neuroimaging and clinical characteristics. Methods: Firstly, we screened a cohort of patients with HCBs from our radiologic information system (RIS) in our center. Secondly, we systematically reviewed published cases on HCBs and classified all these cases according to their etiologies. Finally, we characterized all HCBs cases in detail and classified the disease spectra and their clinical heterogeneity. Results: Out of a total of 3,546 patients who were screened, we identified 40 patients with HCBs imaging sign in our cohort; systemic literature review identified 39 cases, which were associated with 14 diseases. In our cohort, inflammation [neuromyelitis optica spectrum disorders (NMOSD), multiple sclerosis (MS), and acute disseminated encephalomyelitis (ADEM)] and toxicants [toxic encephalopathy caused by phenytoin sodium (TEPS)] were some of the underlying etiologies. Published cases by systemic literature review were linked to metabolic abnormality, degeneration, neoplasm, infection, and stroke. We demonstrated that the clinical phenotype, neuroimaging characteristics, and HCBs response to therapy varied greatly depending on underlying etiologies. Conclusion: This is the first to report HCBs spectra in inflammatory and toxication diseases. Our study and systemic literature review demonstrated that the underpinning disease spectrum may be broader than previously recognized.
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95
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Liang Y, Ding R, Zhu S, Su Y, Ge J. Development of machine learning models to predict response after cardiac resynchronization therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
There have been few practical and precise tools to predict response after cardiac resynchronisation therapy (CRT).
Purpose
We intend to develop predictive models using machine learning (ML) approaches and easily available features prior to implantation.
Methods
The baseline features of 596 patients receiving CRT were retrospectively collected. Nine predictive models were established, including logistic regression (LR), Elastic Net (EN), lasso regression, ridge regression (Ridge), neural network, support vector machine (SVM), random forest, XGBoost and k-nearest neighbor. Sensitivity, specificity, precision, accuracy, F1, area under receiver operating characteristic curve (AU-ROC) and average precision of each model were evaluated, and AU-ROC was compared between each pair of ML models and further between ML models and the latest guidelines.
Results
Sensitivity was highest with SVM by 0.69, and specificity was highest with LR by 0.81. The models EN and Ridge showed the highest overall predictive power with an average AU-ROC of 0.77. Specifically, the Ridge model provided significant higher AU-ROC than any other model (all P<0.05). All ML models showed significant higher AU-ROC than those derived from the latest guidelines (all P<0.05). Additionally, the effect size analysis identified LBBB, LVESD, and history of PCI as the most crucial predictive features.
Conclusion
ML algorithms produced efficient predictive models for evaluation of response after CRT with features prior to implantation. Tools developed accordingly might improve selection of CRT candidates and reduce rate of non-response in the future.
ROC and PR curves of predictive models
Funding Acknowledgement
Type of funding source: None
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96
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Hu Y, Wang Y, Qi Z, He M, Qiu R, Zhu S. Pattern of Recurrence of pT1-3N0M0 Esophageal Squamous Cell Carcinoma After Radical Two-Field Resection. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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97
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Zhu S, Atisha D, Evangelistia M, Barry R, Rama S, Ghosh S, Cannella C, Chen Y, Bensenhaver J, Levin K, Walker E. Factors Associated with Chronic Breast Lymphedema After Adjuvant Radiation in Women Undergoing Breast Conservation Therapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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98
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Zhu S, Khalil R, Altairy O, Burmeister C, Dimitrova I, Elshaikh M. The Prognostic Impact of Time Interval Between Hysterectomy and Initiation of Adjuvant Radiation Treatment in Women With Early-Stage Endometrial Carcinoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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99
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Zhu S, Ghanem A, Morris E, Glide-Hurst C. Inter-Fraction Cardiac Substructure Displacement Quantified by Magnetic Resonance (MR)-Guided Radiation Therapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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100
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Zhu S, Li Q, LI S, Deng W, Zhao Y, Zhao X, Su J. Clinical Outcomes in Different Irradiation Volume for Esophageal Squamous Cell Carcinoma (ESCC) in Definitive Intensity-Modulated Radiotherapy (IMRT) Combined with Concurrent Chemotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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