A bibliometric study on trends in chiropractic research from 1920 to 2023.

OBJECTIVE: An increasing body of evidence suggests a positive role of chiropractic in the treatment of neuro-musculoskeletal disorders. This study aims to explore current research hotspots and trends, providing insights into the broad prospects of this field. METHODS: A bibliometric review was conducted on all chiropractic articles included in the Web of Science Core Collection before December 31, 2023. RESULTS: Over the past century, the volume of research in the field of chiropractic has been fluctuating annually, with four peaks observed in total. The United States, Canada, Australia, and the United Kingdom are leading countries. Chu, Eric Chun-Pu is the author with the most publications, while Bronfort, Gert has the highest total citation count. The University of Southern Denmark has produced the most publications, while Queens University - Canada is the most central institution. The Journal of Manipulative and Physiological Therapeutics is the journal with the most publications and citations, while the Journal of the American Medical Association is the most central journal. The two most-cited articles were both authored by Eisenberg DM. Emerging keywords include "chronic pain" and "skills". The theoretical mechanisms and scientific basis of chiropractic, its clinical practice and safety, education and training, integration with other disciplines, and patient experiences and satisfaction are the frontiers and hotspots of research. CONCLUSION: This study integrates bibliometric analysis to summarize the current state of research and global network centers in the field of chiropractic, further highlighting the hotspots and trends in this field. However, Individual and national rankings should be interpreted with caution due to our focus on Web of Science rather than PubMed.

Multi-omics reveals aging-related pathway in natural aging mouse liver.

Aging is associated with gradual changes in liver structure, altered metabolites and other physiological/pathological functions in hepatic cells. However, its characterized phenotypes based on altered metabolites and the underlying biological mechanism are unclear. Advancements in high-throughput omics technology provide new opportunities to understand the pathological process of aging. Here, in our present study, both metabolomics and phosphoproteomics were applied to identify the altered metabolites and phosphorylated proteins in liver of young (the WTY group) and naturally aged (the WTA group) mice, to find novel biomarkers and pathways, and uncover the biological mechanism. Analysis showed that the body weights, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increased in the WTA group. The grips decreased with age, while the triglyceride (TG) and cholesterol (TC) did not change significantly. The increase of fibrosis, accumulation of inflammatory cells, hepatocytes degeneration, the deposition of lipid droplets and glycogen, the damaged mitochondria, and deduction of endoplasmic reticulum were observed in the aging liver under optical and electron microscopes. In addition, a network of metabolites and phosphorylated proteomes of the aging liver was established. Metabolomics detected 970 metabolites in the positive ion mode and 778 metabolites in the negative ion mode. A total of 150 pathways were pooled. Phosphoproteomics identified 2618 proteins which contained 16621 phosphosites. A total of 164 pathways were detected. 65 common pathways were detected in two omics. Phosphorylated protein heat shock protein HSP 90-alpha (HSP90A) and v-raf murine viral oncogene homolog B1(BRAF), related to cancer pathway, were significantly upregulated in aged mice liver. Western blot verified that protein expression of MEK and ERK, downstream of BRAF pathway were elevated in the liver of aging mice. However, the protein expression of BRAF was not a significant difference. Overall, these findings revealed a close link between aging and cancer and contributed to our understanding of the multi-omics changes in natural aging.

Quantification and Proteomic Characterization of ß-Hydroxybutyrylation Modification in the Hearts of AMPKα2 Knockout Mice.

AMP-activated protein kinase alpha 2 (AMPKα2) regulates energy metabolism, protein synthesis, and glucolipid metabolism myocardial cells. Ketone bodies produced by fatty acid ß-oxidation, especially ß-hydroxybutyrate, are fatty energy-supplying substances for the heart, brain, and other organs during fasting and long-term exercise. They also regulate metabolic signaling for multiple cellular functions. Lysine ß-hydroxybutyrylation (Kbhb) is a ß-hydroxybutyrate-mediated protein posttranslational modification. Histone Kbhb has been identified in yeast, mouse, and human cells. However, whether AMPK regulates protein Kbhb is yet unclear. Hence, the present study explored the changes in proteomics and Kbhb modification omics in the hearts of AMPKα2 knockout mice using a comprehensive quantitative proteomic analysis. Based on mass spectrometry (LC-MS/MS) analysis, the number of 1181 Kbhb modified sites in 455 proteins were quantified between AMPKα2 knockout mice and wildtype mice; 244 Kbhb sites in 142 proteins decreased or increased after AMPKα2 knockout (fold change >1.5 or <1/1.5, p < 0.05). The regulation of Kbhb sites in 26 key enzymes of fatty acid degradation and tricarboxylic acid cycle was noted in AMPKα2 knockout mouse cardiomyocytes. These findings, for the first time, identified proteomic features and Kbhb modification of cardiomyocytes after AMPKα2 knockout, suggesting that AMPKα2 regulates energy metabolism by modifying protein Kbhb.

Exosomes from human umbilical cord mesenchymal stem cells protect aortas in Db/db mice characterized by combination of metabolomics and proteomics.

Diabetic cardiovascular complication is a common systemic disease with high morbidity and mortality worldwide. We hypothesise that exosomes derived from human umbilical cord mesenchymal stem cells (hUCMSCs-exos) can rescue these disorders and alleviate vascular remodeling in diabetes. Morphological, non-targeted metabolomics and 4D label-free proteomics techniques were used to analyze the aortas of db/m mice as normal control group (NCA), saline treated db/db mice (DMA), and hUCMSCs-exos treated db/db mice (DMTA), and to clarify the molecular mechanism of the protection of hUCMSCs-exos in vascular remodeling from a new point of view. The results showed that 74 metabolites were changed significantly in diabetic aortas, of which 15 were almost restored by hUCMSCs-exos. In proteomics, 30 potential targets such as Stromal cell-derived factor 2-like protein 1, Leukemia inhibitory factor receptor, Peroxisomal membrane protein and E3 ubiquitin-protein ligase MYCBP2 were detected. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway-based analysis showed that Central carbon metabolism in cancer and Galactose metabolism pathway were up-regulated to near normal by hUCMSCs-exos in metabolomics, with janus associated kinase-signal transducer and activator of transcription (JAK-STAT) pathway displayed in proteomics. According to bioinformatics and integrated analysis, these targeted molecules of hUCMSCs-exos to attenuate the vascular remodeling were mainly associated with regulation of energy metabolism, oxidative stress, inflammation, and cellular communications. This study provided a reference for the therapy of diabetes-induced cardiovascular complications.

Efficacy and safety of angiogenesis inhibitors in melanoma: a meta-analysis of seven randomized controlled trials.

Little is known about the efficacy and safety of angiogenesis inhibitor therapy in patients with melanoma. The objective of this study was to assess the possible benefits and harms of angiogenesis inhibitor therapy in patients with melanoma. Electronic databases of PubMed and Web of Science were searched from inception to January 2020. Randomized controlled trials (RCTs) that investigated the efficacy and safety of angiogenesis inhibitor therapy in patients with melanoma were included. Primary outcomes were overall survival (OS) and progression-free survival (PFS), reported as hazard ratios (HRs). Secondary outcomes were disease control, objective response, and adverse events, reported as odds ratios (ORs), and trial sequential analysis (TSA) was also performed. We identified seven trials with 3185 patients. There was no significant difference in OS [HR, 0.99; 95% confidence interval (CI), 0.90-1.09] or PFS (HR, 0.91; 95% CI, 0.83-1.00) between the treatment groups. No significant effect of angiogenesis inhibitor therapy was identified on disease control (OR, 1.23; 95% CI, 0.97-1.55) or objective response (OR, 1.27; 95% CI, 0.99-1.62). TSA showed that the sample size for analysis of disease control was sufficient. Additionally, angiogenesis inhibitor therapy increased risks of hypertension, neurological symptoms, and diarrhea. Angiogenesis inhibitor therapy makes no significant improvement in OS or PFS in patients with melanoma and even causes an increased risk of important adverse events. Therefore, angiogenesis inhibitor therapy is not recommended for the treatment of melanoma.

Protection of Exogenous Phosphocreatine for Myocardium in Percutaneous Coronary Intervention Related to Inflammation.

OBJECTIVES: Although injury of myocardium after percutaneous coronary intervention (PCI) has been reported, the mechanism and effect of exogenous phosphocreatine (PCr) supplementation on the injury are yet to be elucidated. Biomarkers, such as interleukin-6 (IL-6) and variations in white blood cells for inflammation, and serum cardiac troponin I (cTnI) for myocardial injury are examined. METHODS: A total of 105 patients undergoing PCI were included and randomly divided into two groups: control (treated with routine hydration therapy) and PCr (treated with additional intravenous infusion of exogenous PCr). The serum levels of biomarkers were detected at administration and 4, 12, 24, and 48 h after PCI, with natural logarithmic (loge) transformation of data when modeling assumptions were not fulfilled. RESULTS: The level of loge-transformed IL-6 increased in both groups, especially at 12 and 24 h after the operation, and that of PCr group was less than the control group at 48 h. The content of loge-transformed cTnI was significantly increased in both groups, while that of the PCr group was markedly lower than the control group at all time points after PCI. Moreover, the ratio of neutrophils was elevated at all time points after PCI, while that of the PCr group was lower at 48 h, and the variations in the ratio of lymphocytes showed opposite results. CONCLUSIONS: Exogenous phosphocreatine reduces stent implantation, triggers inflammation manifested as decreased serum levels of IL-6 and the aggregation of neutrophils, and protects the myocardium of the patients undergoing PCI. These findings provided the potential mechanism and treatment for myocardial injury associated with PCI.

Incidence of injuries in professional snow sports: A systematic review and meta-analysis.

PURPOSE: The study aimed to conduct a comprehensive systematic review and meta-analysis of injury incidence in professional skiers and snowboarders. METHODS: We systematically searched PubMed, Web of Science, and MEDLINE for studies on injury incidence published from inception to April 2020. Injury data were extracted, alongside information on injury location, severity, type, cause, and sport discipline. Incidence of injuries was presented per 1000 athlete-days, with 95% confidence intervals (95%CIs). RESULTS: The search identified 462 articles, and 22 were included in our review. The overall incidence of injuries among professional skiers and snowboarders was 3.49 per 1000 athlete-days (95%CI: 2.97-4.01). Lower extremity had the highest injury incidence (1.54 per 1000 athlete-days, 95%CI: 1.24-1.84). Incidence rates of slight, mild, moderate, and severe injuries were 0.26, 0.31, 0.57, and 0.59 per 1000 athlete-days, respectively. Contusion had the highest incidence rate (1.82 per 1000 athlete-days, 95%CI: 1.01-2.63). The most common cause of injury was contact trauma (3.20 per 1000 athlete-days, 95%CI: 1.32-5.08). Freestyle skiing had the highest incidence rate (6.83 per 1000 athlete-days, 95%CI: 4.00-9.66), and Nordic skiing had the lowest rate (2.70 per 1000 athlete-days, 95%CI: 1.94-3.46). CONCLUSION: Professional skiers and snowboarders have a substantial risk of sustaining injuries. Our findings can be used to inform the planning and provision of healthcare for elite participants in different snow sports.

The Braden Scale for Predicting the Outcome and Prognosis of Pressure Injuries in Older Inpatients: A Multicenter, Retrospective Cohort Study.

INTRODUCTION: The Braden scale is used to assess the risk of patients with pressure injuries (PIs), but there are limitations to the prediction of PI healing. There is a lack of tools for evaluating PI healing and outcome in clinical practice. OBJECTIVE: The purpose of this study was to examine the ability of the Braden scale to predict the outcome and prognosis of PIs in older patients. MATERIALS AND METHODS: Outcome indicator was the wound healing rate of patients with PIs at discharge. The receiver operating characteristic (ROC) and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the discrimination and calibration. RESULTS: Completed data were available for 309 patients, 181 of whom (58.6%) were male. The Braden scale had poor discrimination to predict the outcome and prognosis of PIs with an area under the curve (AUC) of 0.63 (95% CI, 0.56-0.70; P = .01). Subgroup analyses showed the Braden scale had low diagnostic value for patients aged over 90 years (AUCROC = 0.56; 95% CI, 0.17-0.96; P = .738), patients with respiratory diseases (AUCROC = 0.51; 95% CI, 0.37-0.65; P = .908), and digestive system diseases (AUCROC = 0.59; 95% CI, 0.42-0.75; P = .342). The level of calibration ability by Hosmer-Lemeshow goodness-of-fit test was acceptable, defined as P >.200 (χ2 = 6.59; P = .473). In patients aged more than 90 years (χ2 = 4.88; P = .431) and female patients (χ2 = 7.03; P = .425), the Braden scale was also fitting. It was not suitable for patients with respiratory diseases (χ2 = 11.35; P = .078). CONCLUSIONS: The Braden scale had low discrimination for predicting the outcome and prognosis of PIs in older inpatients. The development of a new tool is needed to predict healing in patients with preexisting PIs.

Elevated serum alpha-fetoprotein levels are associated with poor prognosis of hepatocellular carcinoma after surgical resection: A systematic review and meta-analysis.

BACKGROUND AND STUDY AIMS: The relationship between the alpha-fetoprotein (AFP) level and the prognosis of hepatocellular carcinoma (HCC) after surgical resection remains unknown. This study aims to assess this relationship. PATIENTS AND METHODS: PubMed and Web of Science were systematically utilised. Meta-analysis was conducted for the outcomes of the recurrence-free survival (RFS) and the overall survival (OS) by comparing the high AFP group with the low AFP group. RESULTS: The studies included 61 manuscripts with 35,461 patients. The summary hazard ratio (HR) for RFS was 1.501 (95% CI 1.355-1.662; Z = 7.81, P < 0.00001) when comparing the high AFP group with the low AFP group. Sensitivity analysis only included adjusted HRs, with the summary HR being 1.563 (95% CI 1.381-1.768; Z = 7.10, P < 0.00001). The summary HR for OS was 1.565 (95% CI 1.439-1.701; Z = 10.52, P < 0.00001) when comparing two AFP groups. Sensitivity analysis showed that the summary HR was 1.611 (95% CI 1.456-1.782; Z = 9.24, P < 0.00001). CONCLUSION: Our meta-analysis indicated that elevated serum AFP levels are associated with poor prognosis of HCC after surgical resection.

Negative-pressure wound therapy for III/IV pressure injuries: A meta-analysis.

This meta-analysis was conducted to identify the potential benefits and the efficacy of negative-pressure wound therapy (NPWT) for III/IV pressure injuries (PIs) compared with standard wound care (SWC). Sixteen RCTs with 629 patients were included in our analysis. The methodological quality was assessed by the Cochrane Collaboration Tool. The outcomes included complete ulcer healing rate, wound healing time, pain score, the frequency of dressing change, hospitalization cost, the condition of the exudate, and the wound improvement. The percentage of healing rate was 61.45% for the NPWT group and 36.90% for SWC (95% CI: 1.32-1.70). There were significant differences in wound healing time (WMD = -16.47 days, 95% [CI (-22.36, - 10.59) days, P ≤ .001]). The pain score and hospitalization cost in NPWT was lower compared with SWC group (WMD = -2.39, 95% CI [-3.47, -1.30], P ≤ .001); (SMD = -2.55, 95% CI [-4.07, -1.03], P < .01). The frequency of dressing change in both NPWT groups was greatly reduced (SMD = -3.61, 95% [CI (-4.57, - 2.66) times, P ≤ .001]). Our meta-analysis indicated that NPWT was associated with greater improvements in improving PIs and shorting healing time for III/IV PIs. However, this conclusion needs to be confirmed by high-quality multicenter RCTs.

Predicting the Development of Surgery-Related Pressure Injury Using a Machine Learning Algorithm Model.

BACKGROUND: Surgery-related pressure injury (SRPI) is a serious problem in patients who undergo cardiovascular surgery. Identifying patients at a high risk of SRPI is important for clinicians to recognize and prevent it expeditiously. Machine learning (ML) has been widely used in the field of healthcare and is well suited to predictive analysis. PURPOSE: The aim of this study was to develop an ML-based predictive model for SRPI in patients undergoing cardiovascular surgery. METHODS: This secondary analysis of data was based on a single-center, prospective cohort analysis of 149 patients who underwent cardiovascular surgery. Data were collected from a 1,000-bed university-affiliated hospital. We developed the ML model using the XGBoost algorithm for SRPI prediction in patients undergoing cardiovascular surgery based on major potential risk factors. Model performance was tested using a receiver operating characteristic curve and the C-index. RESULTS: Of the sample of 149 patients, SRPI developed in 37, an incidence rate of 24.8%. The five most important predictors included duration of surgery, patient weight, duration of the cardiopulmonary bypass procedure, patient age, and disease category. The ML model had an area under the receiver operating characteristic curve of 0.806, which indicates that the ML model has a moderate prediction value for SRPI. CONCLUSIONS: Applying ML to clinical data may be a reliable approach to the assessment of the risk of SRPI in patients undergoing cardiovascular surgical procedures. Future studies may deploy the ML model in the clinic and focus on applying targeted interventions for SRPI and related diseases.

Incidence of suicide death in patients with cancer: A systematic review and meta-analysis.

BACKGROUND: Growing evidence indicated the higher risk of suicide in cancer survivors compared with general population. Our aim is to systematically quantify the extent of suicide death and identify risk factors associated with the incidence of suicide in cancer patients. METHODS: We conducted a meta-analysis of relevant studies published in English or Chinese before May 20, 2020. Suicide rate and the number of suicide death were extracted. Our main outcome was suicide rate per 100,000 person-years with 95% CIs using random-effects model. RESULTS: The pooled incidence of suicide death was 39.72 per 100,000 person-years (95%CI, 33.91-46.52, I 2= 99.6%, P <0 .001). The suicide rate for cancer patients was higher in men (57.78, 95%CI, 47.31-70.56) than in women (14.47, 95%CI, 11.27-18.57). For both sexes combined, esophagus cancer had the highest rate of suicide (87.71, 95%CI, 27.42-280.54). By sex, suicide rates ranked first in males and females were pancreas cancer (195.70, 95%CI, 129.55-295.61) and esophagus cancer (18.34, 95%CI, 5.92-56.84), respectively. The highest suicide rate was 61.02(95%CI, 53.66-69.40) in Asia, and Oceania (24.07, 95%CI, 20.78-27.88) had lowest suicide rate. Suicide rate had a downward trend by years after diagnosis, with the first six months after cancer diagnosis clearly standing out (89.33, 95%CI, 50.64-157.58). LIMITATIONS: Included studies came from high-income countries and our results might not represent the suicide rate among cancer patients in low- and middle-income countries. CONCLUSIONS: The incidence of suicide among cancer patients was high despite the declined trend recent years, which emphasized psychological health aspects of interventions and perfecting suicide prevention programs.

Incidence of Pressure Injury in Individuals With Spinal Cord Injury: A Systematic Review and Meta-analysis.

PURPOSE: The purpose of this systematic review and quantitative analysis of pooled data was to assess the global incidence of pressure injury (PI), across time frames and countries, in individuals with spinal cord injury (SCI). DESIGN: Systematic review and meta-analysis. SEARCH STRATEGY: PubMed, Web of Science, and EMBASE databases were systematically searched for studies published from database inception to January 2019, with only English language studies that reported the incidence of PIs in individuals with SCI were included. Study quality was assessed by a 14-item standardized checklist. We calculated the incidence of PIs as the number of new PIs in individuals with SCI and the total number of individuals with SCI during the study period. Findings are presented as incidence rate with 95% confidence intervals (CIs). RESULTS: The search yielded 1652 studies; after studies were reviewed for inclusion criteria, 29 studies representing N = 82,722 patients were retained for data extraction. The global incidence of PIs was 0.23 (95% CI, 0.20-0.26). Data for regional distribution by country showed a pooled incidence of 0.43 (95% CI, 0.28-0.57) in individuals with SCI in South American countries, 0.36 (95% CI, 0.16-0.56) in African countries, 0.25 (95% CI, 0.14-0.37) in European countries, 0.23 (95% CI, 0.19-0.27) in North American countries, and 0.16 (95% CI, 0.06-0.25) in Asian countries. The incidence was 0.22 (95% CI, 0.19-0.26) in developing countries versus 0.27 (95% CI, 0.17-0.37) in developed countries. From 2000 to 2009, the incidence of PIs in individuals with SCI was 0.28 (95% CI, 0.09-0.47). The incidence rate of PIs before 2000 and after 2009 was 0.23. The hospital- and community-acquired PI incidence was 0.22 (95% CI, 0.19-0.26) and 0.26 (95% CI, 0.20-0.32), respectively. CONCLUSIONS: Study findings indicate that more than 1 in 5 individuals with SCI will develop a PI. Individuals with SCI are at high risk of developing PI, especially in community settings or low- and middle-income developing countries. The findings highlight the importance of further investigation of risk factors and prevention and management strategies for PIs in individuals with SCI.

Zinc Therapy Is a Reasonable Choice for Patients With Pressure Injuries: A Systematic Review and Meta-Analysis.

The aim of this systematic review was to summarize the evidence on the efficacy of zinc supplementation in patients with pressure injuries (PIs). Electronic data bases (Embase, MEDLINE, and Web of Science) were searched from inception to 2019 for randomized controlled trials (RCTs) and non-RCTs addressing the efficacy of zinc supplementation compared with a control nutrition invention on PI outcomes. The primary study outcome was the healing rate of PIs during treatment; the secondary outcomes were the improvement of PI area and pressure ulcer scale for healing (PUSH) score. A total of 7 studies were included in this systematic review and meta-analysis. The intervention group significantly had improved healing vs that of the control group (relative risk, 1.44; 95% CI, 1.01-2.06; P = 0.043, I2 = 19.3%). There was no obvious asymmetry in the funnel plot and no strong evidence of publication bias. Sensitivity analysis showed that meta-analysis has good stability. Studies showed a greater mean reduction in PI area. All the studies we included had a significant improvement in the PUSH score of PIs. Our systematic review and meta-analysis from clinical research confirmed that zinc therapy can promote wound healing and suggest that medical staff should consider providing patients with zinc during PI treatment.

The relationship between pressure injury complication and mortality risk of older patients in follow-up: A systematic review and meta-analysis.

Pressure injuries (PIs) have now become a common complication of the elderly patients. Some studies have observed that pressure injuries may increase mortality, but this area of evidence has not been evaluated and summarised. The aim of this study was to compare the mortality of patients with pressure injuries and those without pressure injuries. A meta-analysis of observational studies was performed. PubMed, Cochrane Library, Embase, and Web of Science were searched up to April 2019. Studies about mortality among the elderly patients with and without pressure injuries were included. Methodological quality was assessed by the Newcastle-Ottawa Scale (NOS). The fixed effect or random effect model was determined by the test of heterogeneity. The subgroup analysis was performed based on the pressure injuries stages, the region, and the type of study design. The meta-regression analysis was performed to investigate the relationship between the mortality and patients' enrolled year, average age, the incidence of pressure injuries, and gender ratio. The sensitivity analysis was used to explore the impact of an individual study by excluding one at a time. The hazard ratio (HR) and 95% confidence intervals (CIs) in terms of the comparison of two groups were extracted for meta-analysis. A survival curve between two groups by individual patient-level was drew. Eight studies with 5523 elderly patients were included in the analysis. Follow-up periods for the included studies ranged from about 0.5 to 3 years. The elderly patients who complicated with pressure injuries had a higher risk of death. The pooled HR was 1.78 (95% CI 1.46-2.16). A funnel plot showed no publication bias. Further subgroup analysis showed that HR values for the patient stage 3 to 4 pressure injuries (HR:2.41; 95% CI:1.08-5.37) were higher than stage 1-4 and 2-4 pressure injuries (HR: 1.66; 95% CI: 1.35-2.05; HR: 1.74; 95% CI: 1.16-2.60). The meta-regression analysis found that patients' enrolled year, average age, the incidence of pressure injuries, and gender ratio were not the sources of heterogeneity. Sensitivity analyses showed that the outcomes of the study did not change after removing the Onder's article. The survival curve at the individual patient-level also indicated that patients complicated with pressure injuries significantly increased the risk of death (HR: 1.958; 95% CI: 1.79-2.14) in elderly patients. Our meta-analysis indicated that patients complicated with pressure injuries are estimated to have a two times higher risk on mortality compared with patients without pressure injuries during the 3 years follow-up period. Particular attention should be given to the elderly patients who are at higher risk for mortality.