Global, regional, and national burden of oral cancer and its attributable risk factors from 1990 to 2019.

BACKGROUND: This study aims to provide a theoretical basis for the prevention of oral cancer by analyzing the epidemiological trends of oral cancer. MATERIALS AND METHODS: The data on oral cancer from 1990 to 2019 were extracted from the Global Burden of Disease 2019 database. The incidence, mortality, disability-adjusted life years (DALYs), and age-standardized rate as well as attributable risk factors of oral cancer were used for the analysis. Estimated annual percentage change (EAPC) was calculated to describe the changes in age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). RESULTS: The global ASIR of oral cancer showed an increasing trend from 1990 to 2019. ASIR in high SDI regions showed a decreasing trend during the studied period, with high SDI regions having the lowest ASMR in 2019. In 2019, the highest ASIR, ASMR, and ASDR were detected in South Asia. At the national level, Pakistan had the highest ASMR and ASDR in 2019. The increasing disease burden was observed in younger populations aged below 45 during the studied period. Smoking and alcohol use still exerted profound impacts on the oral cancer burden, with South Asia having the greatest increase in the percentage of deaths due to oral cancer attributable to chewing tobacco from 1990 to 2019. CONCLUSION: In conclusion, there is a large variability in the temporal and spatial burden of oral cancer, and it is essential for priority countries to take targeted intervention policies and measures to reduce the disease burden of oral cancer. In addition, the oral cancer burden caused by attributable risk factors should also receive close attention.

Prognostic Outcome of New-Onset Left Bundle Branch Block After Transcatheter Aortic Valve Replacement in Patients With Aortic Stenosis: A Systematic Review and Meta-Analysis.

Background: Left bundle branch block (LBBB) is a common complication of the transcatheter aortic valve replacement (TAVR), and its impact on prognosis is controversial. Methods: A comprehensive electronic search was conducted in databases (PubMed, Embase, Cochrane Library, and The Web of Science), from the date of database establishment till March 2021, to screen for studies on new-onset LBBB after TAVR. We next performed a meta-analysis to evaluate the effect of new-onset LBBB after TAVR on patient prognosis, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: A total of 17 studies, including 9205 patients, were eligible for our analysis. Patients with new-onset LBBB had elevated all-cause mortality risk verses patients without new-onset LBBB, during all follow ups. The relevant data are as follows: 30-day (RR:1.71; 95%CI:1.27-2.29; P < 0.001), 1-year (RR:1.31; 95%CI:1.12-1.52; P < 0.001), and 2-year (RR:1.31; 95%CI:1.09-1.56; P = 0.003) follow ups. Likewise, new-onset LBBB patients also experienced increased cardiovascular mortality, compared to non-new-onset LBBB patients, but only in the 1-year follow up (RR:1.49; 95%CI:1.23-1.82; P < 0.001). Hospitalization for heart failure was dramatically elevated in patients with new-onset LBBB verses non-new-onset LBBB, in all follow ups. The relevant data are as follows: 30-day (RR:1.56; 95%CI:1.13-2.12; P = 0.007), 1-year (RR:1.35; 95%CI:1.08-1.68; P = 0.007), and 2-year (RR:1.49; 95%CI:1.21-1.84; P < 0.001). Similarly, new-onset LBBB patients had higher PPI risk than non-new-onset LBBB patients, in all follow ups. The relevant data are as follows: 30-day (RR:3.05; 95%CI:1.49-6.22; P = 0.002), 1-year (RR:2.15; 95%CI:1.52-3.03; P < 0.001), and 2-year (RR:2.52; 95%CI:1.68-3.78; P < 0.001). Conclusion: Patients with new-onset LBBB have worse prognosis after TAVR than those without new-onset LBBB. Recognition of the adverse effects of post-TAVR new-onset LBBB can lead to the development of new strategies that enhance clinical outcomes. Systematic Trial Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=197224, identifier: 19722.

Impact of Chronic Kidney Disease on the Prognosis of Transcatheter Aortic Valve Replacement in Patients with Aortic Stenosis: A Meta-Analysis of 133624 Patients.

PURPOSE: The impact of chronic kidney disease (CKD) on the prognosis of transcatheter aortic valve replacement (TAVR) remains unclear. The purpose of this meta-analysis was to assess the impact of CKD and different stages of CKD on prognosis in patients undergoing TAVR. METHODS: As of June 2020, we performed a comprehensive literature search on relevant studies using PubMed, Embase, Cochrane Library, and Web of Science. Subsequently, we pooled the risk ratio (RR) of individual studies via random effects to analyze heterogeneity, quality assessment, and publication bias. RESULTS: A total of 20 studies, involving 133624 patients, were eligible for analysis. Patients with CKD had higher all-cause mortality at 30 days (RR: 1.39, 95% confidence interval [CI]: 1.31-1.47, P <0.001), 1 year (RR: 1.36, 95% CI: 1.24-1.49, P <0.001), and 2 years (RR: 1.2, 95% CI: 1.05-1.38, P = 0.009) of follow-up. Moreover, they also had higher acute kidney injury (AKI) (RR: 1.38, 95% CI: 1.16-1.63, P <0.001) and bleeding (RR: 1.33, 95% CI: 1.18-1.50, P <0.001) at 30 days. CKD3 alone also increased all-cause mortality at follow-ups. Risk of all-cause mortality increased with severity of CKD for stages 3, 4, and 5 at follow-up. CONCLUSION: Patients with CKD are at an increased risk of all-cause mortality, AKI, and bleeding events after TAVR. Moreover, the mortality risk rises with increasing severity of CKD.

Impact of chronic kidney disease on the prognosis of transcatheter aortic valve replacement in patients with aortic stenosis: A protocol for systematic review and meta-analysis.

BACKGROUND: The prognosis of patients with aortic stenosis, in conjunction with chronic kidney disease (CKD), after transcatheter aortic valve replacement (TAVR) remains unclear. This study assessed the impact of CKD, and different stages of CKD, on prognosis of patients undergoing TAVR. METHODS: The protocol was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement guidelines. As of June 2021, we performed a comprehensive literature search on studies related to CKD and TAVR, using databases such as PubMed, Embase, Cochrane Library, and Web of Science. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Then, Stata 15.0 software was used for meta-analysis. RESULTS AND CONCLUSION: The purpose of this study was to evaluate the effect of CKD and different stages of CKD on the prognosis of patients with TAVR. It is hoped to provide a comprehensive reference for clinical practice and related clinical trials in the future.

Comparison of results of transcatheter femoral aortic valve replacement under local and general anesthesia: A protocol for systematic review and meta-analysis.

BACKGROUND: Traditionally, TAVR (Transcatheter Aortic Valve Replacement) has been performed under general anesthesia (GA). Thus GA facilitates the use of TEE (Transesophageal echocardiography), and the use of TEE is an important means to improve the quality of cardiac surgery and reduce postoperative complications. However, GA was also associated with prolonged mechanical ventilation, longer hospitalization and intensive care unit hours, and the need for positive inotropic agents. With increasing clinical experience and advances in transcatheter techniques, transfemoral TAVR may also be feasible under local anesthesia (LA). Studies have shown that LA can avoid hemodynamic fluctuations caused by general anesthesia and lung damage caused by positive pressure ventilation, and can also reduce medical costs. METHODS: Two researchers independently read the titles and abstracts of the literature obtained. After excluding the studies that did not meet the inclusion criteria, they read through the full text of the remaining literatures to determine whether they truly met the inclusion criteria. When two researchers disagree on the included literature, the third researcher decides whether to include it or not. For literature with incomplete data, contact the author via email for unpublished data. The included studies were assessed by two researchers for the risk of bias, and cross-checked. Stata16.0 was used for meta-analysis. Heterogeneity was assessed by χ2 test and I2 quantification. Pooled analysis was performed by random effects model. Sensitivity analysis was performed by excluding references one by one. We will perform subgroup analysis based on data conditions. RESULTS: In this study, high quality evidence was provided by selecting local anesthesia and general anesthesia during transfemoral transcatheter aortic valve replacement for patients with primary arterial stenosis. CONCLUSION: Local anesthesia provides anaesthetic-guided sedation that does not require intubation and is safe and effective. Local anesthesia may be a better alternative to TAVR under general anesthesia. ETHICS AND DISSEMINATION: The study does not require ethical approval. INPLASY REGISTRATION NUMBER: INPLASY202170078.

The interventional effects of loving-kindness meditation on positive emotions and interpersonal interactions.

The study aimed to investigate the effects of loving-kindness meditation on positive emotions, intragroup interactions, and complex understanding of others. A total of 50 freshmen not receiving any training in meditation intervention were randomly divided into the meditation group (25 subjects) and the control group (25 subjects). The meditation group was implemented with group meditation intervention for 4 weeks, three times a week, about 30 minutes each time. The results revealed that the effect sizes in interpersonal interaction and complex understanding of others in the meditation group were both above 0.8, indicating strong effects. It was concluded that loving-kindness meditation can effectively improve positive emotions, interpersonal interactions, and complex understanding of others in college students.