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BACKGROUND: The accurate selection of patients likely to respond to renal denervation (RDN) is crucial for optimizing treatment outcomes in patients with hypertension. This systematic review was designed to evaluate patient-specific factors predicting the RDN response. METHODS AND RESULTS: We focused on individuals with hypertension who underwent RDN. Patients were categorized based on their baseline characteristics. The primary outcome was blood pressure (BP) reduction after RDN. Both randomized controlled trials and nonrandomized studies were included. We assessed the risk of bias using corresponding tools and further employed the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the overall quality of evidence. A total of 50 studies were ultimately included in this systematic review, among which 17 studies were for meta-analysis. Higher baseline heart rate and lower pulse wave velocity were shown to be associated with significant antihypertensive efficacy of RDN on 24-hour systolic BP reduction (weighted mean difference, -4.05 [95% CI, -7.33 to -0.77]; weighted mean difference, -7.20 [95% CI, -9.79 to -4.62], respectively). In addition, based on qualitative analysis, higher baseline BP, orthostatic hypertension, impaired baroreflex sensitivity, and several biomarkers are also reported to be associated with significant BP reduction after RDN. CONCLUSIONS: In patients with hypertension treated with the RDN, higher heart rate, and lower pulse wave velocity were associated with significant BP reduction after RDN. Other factors, including higher baseline BP, hypertensive patients with orthostatic hypertension, BP variability, impaired cardiac baroreflex sensitivity, and some biomarkers are also reported to be associated with a better BP response to RDN.
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Presión Sanguínea , Hipertensión , Riñón , Humanos , Hipertensión/fisiopatología , Hipertensión/cirugía , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Riñón/inervación , Riñón/fisiopatología , Presión Sanguínea/fisiología , Resultado del Tratamiento , Simpatectomía/métodos , Frecuencia Cardíaca/fisiología , Análisis de la Onda del Pulso , Arteria Renal/inervación , Barorreflejo/fisiologíaRESUMEN
The value of cardiovascular magnetic resonance (CMR) in assessing and predicting acute right ventricular (RV) dysfunction in patients with anterior ST-segment elevation myocardial infarction (STEMI) remains ascertained. Eighty eight patients with anterior STEMI were prospectively recruited and underwent CMR examinations within one week following the coronary intervention. Patients with RV ejection fraction (RVEF) less than 2 standard deviations below the average at the center (RVEF ≤ 45.0%) were defined as having RV dysfunction. The size of infarction, segmental wall motion, and T1 and T2 mapping values of global myocardium and the interventricular septum (IVS) were measured. Predictive performance was calculated using receiver-operating characteristic curve analysis and logistic regression test. Twenty two patients presented with RV dysfunction. The RV dysfunction group had a larger IVS infarct extent (54.28 ± 10.35 vs 33.95 ± 15.09%, P < 0.001) and lower left ventricle stroke volume index (33.93 ± 7.96 vs 42.46 ± 8.14 ml/m2, P < 0.001) compared to the non-RV dysfunction group. IVS infarct extent at 48.8% best predicted the presence of RV dysfunction with an area under the curve of 0.864. Left ventricular stroke volume index (LVSVI) and IVS infarct extent were selected by stepwise multivariable logistic regression analysis. Lower LVSVI (odds ratio [OR] 0.90; 95% confidence interval [CI], 0.79 to 0.99; P = 0.044) and higher IVS infarct extent (OR 1.16; 95% CI 1.05 to 1.33; P = 0.01) were found to be independent predictors for RV dysfunction. In patients with anterior STEMI, those with larger IVS infarct extent and worse LV function are more likely to be associated with RV dysfunction.
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BACKGROUND: With the exponential growth of publications in the field of investigator-initiated research/trials (IIRs/IITs), it has become necessary to employ text mining and bibliometric analysis as tools for gaining deeper insights into this area of study. By using these methods, researchers can effectively identify and analyze research topics within the field. METHODS: This study retrieved relevant publications from the Web of Science Core Collection and conducted bioinformatics analysis. The latent Dirichlet allocation model, which is based on machine learning, was utilized to identify subfield research topics. RESULTS: A total of 4315 articles related to IIRs/IITs were obtained from the Web of Science Core Collection. After excluding duplicates and articles with missing abstracts, a final dataset of 3333 articles was included for bibliometric analysis. The number of publications showed a steady increase over time, particularly since 2000. The United States, Germany, the United Kingdom, the Netherlands, Canada, Denmark, Japan, Switzerland, and France emerged as the most productive countries in terms of IIRs/IITs. The citation analysis revealed intriguing trends, with certain highly cited articles showing a significant increase in citation frequency in recent years. A model with 45 topics was deemed the best fit for characterizing the extensively researched fields within IIRs/IITs. Our analysis revealed 10 top topics that have garnered significant attention, spanning domains such as community health, cancer treatment, brain development and disease mechanisms, nursing research, and stem cell therapy. These top topics offer researchers valuable directions for further investigation and innovation. Additionally, we identified 12 hot topics, which represent the most cutting-edge and highly regarded research areas within the field. CONCLUSION: This study contributes to a comprehensive understanding of the current research landscape and provides valuable insights for researchers working in this domain.
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Bibliometría , Biología Computacional , Humanos , Canadá , Minería de Datos , FranciaRESUMEN
Guidance documents play a pivotal role in shaping the management of status epilepticus (SE). However, the methodological quality of these documents remains uncertain. In this systematic review, we comprehensively searched 12 literature and guideline databases to assess the quality of clinical practice guidelines and consensus statements related to SE management using the AGREE II methodology. Additionally, we summarized the associated recommendations. We identified a total of 14 clinical practice guidelines and 11 consensus statements spanning the period from 1993 to 2022. The median score for clarity of presentation was 71.8% (ranging from 15.3% to 91.7%), indicating generally good clarity. However, the aspect of editorial independence received poor ratings, with a median score of 32.1% (ranging from 0% to 83.3%). Notably, the 2016 guideline published by the American Epilepsy Society in Epilepsy (AES) received the highest overall scores. Across these guidance documents, there was consistency in the definition and diagnosis of SE. However, significant variability was observed in therapeutic recommendations, particularly in terms of the timing for adding or changing medications. The methodological approaches used in most SE guidance documents require improvement, and the disparities in recommendations highlight existing gaps in evidence. Enhanced methodological rigor results in increased standardization of the guideline, consequently augmenting its reference value. Given the urgency of SE as an emergency condition, it is imperative that these documents also address relevant management strategies before admission.
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Epilepsia , Estado Epiléptico , Humanos , Consenso , Hospitalización , Estado Epiléptico/diagnóstico , Estado Epiléptico/terapia , Estados Unidos , Guías de Práctica Clínica como AsuntoRESUMEN
Patent foramen ovale (PFO) is a common congenital cardiac abnormality when the opening of the interatrial septum is not closed in adulthood. This abnormality affects 25% of the general population. With the development of precision medicine, an increasing number of clinical studies have reported that PFO is closely related to various neurological diseases such as stroke, migraine, obstructive sleep apnea, and decompression syndrome. It has also been suggested that PFO closure could be effective for preventing and treating these neurological diseases. Therefore, increasing attention has been given to the prevention, diagnosis, and treatment of PFO-related neurological diseases. By reviewing existing literature, this article focuses on the pathogenesis, epidemiology, and clinical characteristics of PFO-related neurological diseases, as well as the prevention and treatment of different neurological diseases to discuss, and aims to provide current progress for this field and decision-making evidence for clinical practice.
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Logic-in-memory devices are a promising and powerful approach to realize data processing and storage driven by electrical bias. Here, an innovative strategy is reported to achieve the multistage photomodulation of 2D logic-in-memory devices, which is realized by controlling the photoisomerization of donor-acceptor Stenhouse adducts (DASAs) on the surface of graphene. Alkyl chains with various carbon spacer lengths (n = 1, 5, 11, and 17) are introduced onto DASAs to optimize the organic-inorganic interfaces: 1) Prolonging the carbon spacers weakens the intermolecular aggregation and promotes isomerization in the solid state. 2) Too long alkyl chains induce crystallization on the surface and hinder the photoisomerization. Density functional theory calculation indicates that the photoisomerization of DASAs on the graphene surface is thermodynamically promoted by increasing the carbon spacer lengths. The 2D logic-in-memory devices are fabricated by assembling DASAs onto the surface. Green light irradiation increases the drain-source current (Ids ) of the devices, while heat triggers a reversed transfer. The multistage photomodulation is achieved by well-controlling the irradiation time and intensity. The strategy based on the dynamic control of 2D electronics by light integrates molecular programmability into the next generation of nanoelectronics.
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Total knee arthroplasty (TKA) is considered a common surgical option in patients with end-stage osteoarthritis of the knee. This systematic review and meta-analysis aimed to determine the effectiveness of cognitive behavioral therapy (CBT) for patients after TKA. PubMed, EMBASE, the Cochrane Library, Web of Science and CINAHL were searched for randomized controlled trials (RCTs) from inception to 20 August 2021. Included studies were evaluated with the Cochrane risk-of-bias tool. Six RCTs were included. Our study results demonstrated that a significant reduction in pain catastrophing was seen in patients receiving CBT at post-intervention (SMD -0.48, 95% CI = -0.72 to -0.23, I2 17.2%, p = 0.00) but not in 3-month or 12-month follow-up. There were no significant differences between CBT and usual-care patients regarding pain intensity or knee function at different time-points. This is the first time that meta-analysis has been conducted to determine the effectiveness of CBT for patients after TKA. It is necessary to conduct longer follow-ups, include larger samples and conduct rigorous RCTs to further explore this issue.
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The emerging material GeMnTe2 provides a rare example to study the spin degree of freedom in thermoelectric transport, as it exhibits an anomalous Seebeck coefficient driven by the spin's thermodynamic entropy. This work presents an unconventional strategy to optimize the thermoelectric performance of GeMnTe2 by manipulating the spin degree of freedom. NaBiTe2 is alloyed into GeMnTe2 to disorder the spin orientation under finite temperature, and the obtained Seebeck coefficient is confirmed to be dramatically enhanced by more than 150%. The measurements of XRD and magnetic susceptibility indicate that the increased Seebeck coefficient is due to the increase of the spin's thermodynamic entropy. Finally, the maximum ZT of 1.06 at 820 K is obtained in Ge0.8Na0.1Bi0.1MnTe2. This work enriches the physical picture of spin degree of freedom in thermoelectric materials.
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Bismuth telluride has been the only commercial thermoelectric candidate, but the n-type sintered material lags well behind the p-type one in the zT value, which severely limits the further development of thermoelectrics. Here, we report a promising technique named hot-stacked deformation to effectively improve the thermoelectric properties of n-type Bi2Te2.79Se0.21 + 0.067 wt % BiCl3 materials based on zone-melting ingots. It is found that a high grain alignment is maintained during the plastic deformation and the carrier concentration is properly optimized owing to the donor-like effect, leading to an enhanced power factor. Moreover, the lattice thermal conductivity is obviously suppressed due to the emerged phonon scattering centers of dense grain boundaries and dislocations. These effects synergistically yield a maximum zT value of 1.38 and an average zTave of 1.18 between 300 and 500 K in the hot-stacked deformed sample, which is approximately 42% higher than those of the zone-melting ingots.
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Constructing a nanocomposite to introduce a coherent interface is an effective way to improve the property of thermoelectric material. Here, a series composites of Bi0.48Sb1.52Te3-x wt % Sb2Te3 (x = 0, 0.3, 0.5, 0.8, and 1.0) were synthesized, where the hydrothermally prepared Sb2Te3 nanosheets were intimately wrapped in the solid-state-reacted Bi0.48Sb1.52Te3 matrix. The formation of a coherent interface was observed and confirmed by the scanning electron microscopy characterization. As the Sb2Te3 content was over 0.5 wt %, the carrier mobility could increase by 26%, while the carrier concentration decreased by 9% compared to those of the pure matrix at 300 K, enhancing the power factor to 40.1 µW/cm K2. Moreover, the Bi0.48Sb1.52Te3-0.5 wt % Sb2Te3 sample exhibited a reduced lattice thermal conductivity of 0.83 W/m K at room temperature, resulting from the strengthened phonon scattering by interfaces. Combined with the manipulations of both the electronic and thermal transport by constructing a coherent interface, a maximum ZT of 1.05 was obtained in the x = 0.5 composite at 300 K, and it was improved by 20% compared with the result of the Bi0.48Sb1.52Te3 matrix.