Multivariable machine learning models for clinical prediction of subsequent hip fractures in older people using the Chinese population database.

PURPOSE: This study aimed to develop and validate clinical prediction models using machine learning (ML) algorithms for reliable prediction of subsequent hip fractures in older individuals, who had previously sustained a first hip fracture, and facilitate early prevention and diagnosis, therefore effectively managing rapidly rising healthcare costs in China. METHODS: Data were obtained from Grade A Tertiary hospitals for older patients (age ≥ 60 years) diagnosed with hip fractures in southwest China between 1 January 2009 and 1 April 2020. The database was built by collecting clinical and administrative data from outpatients and inpatients nationwide. Data were randomly split into training (80%) and testing datasets (20%), followed by six ML-based prediction models using 19 variables for hip fracture patients within 2 years of the first fracture. RESULTS: A total of 40,237 patients with a median age of 66.0 years, who were admitted to acute-care hospitals for hip fractures, were randomly split into a training dataset (32,189 patients) and a testing dataset (8,048 patients). Our results indicated that three of our ML-based models delivered an excellent prediction of subsequent hip fracture outcomes (the area under the receiver operating characteristics curve: 0.92 (0.91-0.92), 0.92 (0·92-0·93), 0.92 (0·92-0·93)), outperforming previous prediction models based on claims and cohort data. CONCLUSIONS: Our prediction models identify Chinese older people at high risk of subsequent hip fractures with specific baseline clinical and demographic variables such as length of hospital stay. These models might guide future targeted preventative treatments.

Effect of Baduanjin qigong on postoperative pulmonary rehabilitation in patients with non-small cell lung cancer: a randomized controlled trial.

PURPOSE: The purpose of this study was to explore the effect of Baduanjin qigong on improving lung function and postoperative quality of life of patients with non-small cell lung cancer (NSCLC) and to find an effective home-based pulmonary rehabilitation method. METHODS: A randomised controlled trial was carried out from July 2019 to October 2021, which included 216 NSCLC postoperative participants from Beijing China-Japan Friendship Hospital and Cancer Hospital of Chinese Academy of Medical Science. Participants were randomly divided into two groups, including the observation (n = 108) group and the control group (n = 108). The control group was given routine lung rehabilitation training, while the observation group was given Baduanjin qigong. Both groups were trained for 12 weeks.The patient's age, sex, smoking history, lung cancer stage, pathological type were recorded. Related indicators of lung function, 6-min walk distance(6MWD), Piper fatigue Scale, and Borg dyspnea score before and after intervention were recorded. RESULTS: Compared with these indicators before indicators, lung function, 6MWD, Piper fatigue Scale score and Borg score were significantly better in the two groups after intervention (P < 0.05). There were no significant differences in FVC%, 6MWD and Borg score between the two groups (P > 0.05), whereas FEV1% and Piper fatigue Scale scores in the observation group were better than that in the control group (P < 0.05). CONCLUSION: Both Baduanjin qigong and traditional pulmonary rehabilitation methods can improve the postoperative lung function and quality of life of patients with NSCLC; and compared with traditional pulmonary rehabilitation training, Baduanjin Qigong may have certain advantages in relieving cancer-related fatigue and FEV1%, and may be another new method of home-based pulmonary rehabilitation for patients with NSCLC. TRIAL REGISTRATION: Clinical Trial No.: ChiCTR1900025121.

An exercise prescription for patients with lung cancer improves the quality of life, depression, and anxiety.

Introduction: Lung cancer has the highest rates of morbidity and mortality among all cancers. Patients with lung cancer inevitably confront psychosocial discomforts and progressively experience depression and anxiety that potentially impact the clinical outcomes [e.g., quality of life (QoL)]. These mental disorders in patients with lung cancer may effectively be alleviated with prescribed Chinese traditional mind-body exercises. This study aimed to determine the effect of the exercise prescription containing Chinese traditional mind-body exercise on QoL, depression, and anxiety in patients with lung cancer. Methods: In this study, 52 patients with non-small cell lung cancer (NSCLC) recruited from the China-Japan Friendship Hospital were divided into two groups, namely, the experimental group (N = 26) and the control group (N = 26). The experimental group was treated with an 8-week exercise prescription containing aerobic and resistance training. The control group received the usual care during the study period. The QoL, depression, and anxiety were separately investigated using EORTC QLQ-C30, EORTC QLQ-LC13, the Self-Rating Depression Scale (SDS), and the Self-Rating Anxiety Scale (SAS) at baseline and post-intervention. The scores of questionnaires were analyzed using the paired sample and independent sample t-tests to explore the intragroup and intergroup differences, respectively. Results: The EORTC QLQ-C30 scores for physical functioning, role functioning, emotional functioning, and global QoL in the experimental group at post-intervention were significantly higher than those at baseline. The EORTC QLQ-C30 scores for fatigue, pain, dyspnea, and insomnia in the experimental group at post-intervention were significantly lower than those at the baseline. The SDS scores (baseline: 57.74 ± 8.77 vs. post-intervention: 51.42 ± 7.31, p < 0.05) and the SAS scores (baseline: 56.63 ± 9.39 vs. post-intervention: 49.16 ± 7.83, p < 0.05) in the experimental group at post-intervention were significantly lower than those at baseline. Conclusions: The 8-week exercise prescription containing moderate-intensity Baduanjin (5 days per week) can effectively alleviate QoL, depression, and anxiety in patients with NSCLC. Our exercise prescription is an effective supportive treatment for lung cancer patients with depression and anxiety. Clinical trial registration: Chinese Clinical Trial Registry (ChiCTR1900025121).

A cumulative Bayesian network meta-analysis on the comparative efficacy of pharmacotherapies for mania over the last 40 years.

RATIONALE: Mania (or manic episodes) is a common symptom of bipolar disorder and is frequently accompanied by hyperactivity and delusions; given the cost and resources available, there is a paucity of evidence for direct comparison of different drugs. OBJECTIVES: We aimed to provide evidence-based recommendations on the efficacy of overall currently used pharmacological treatments for patients with acute bipolar mania. METHOD: We conducted a systematic review and network meta-analysis (NMA) using a Bayesian network frame. We searched the primary literature databases without language restrictions until Dec 18, 2021, for reports of randomized controlled trials (RCTs) of suspected antimanic drugs used as monotherapy for patients with acute bipolar mania, with the primary outcomes being efficacy (mean difference (MD), standardized mean difference (SMD) in the change of mania score). RESULTS: Eighty-seven studies were included in which 18,724 manic participants (mean age = 34.6 years, with 50.36% males) were allocated at random to one of 25 active medication drug therapies or placebo, resulting in 87 direct comparisons on 192 data points. Tamoxifen (- 22·00 [- 26·00 to - 18·00]) had the best efficacy over the placebo. Meanwhile, risperidone (- 6·60 [- 8·40 to - 4·90]) was substantially more effective than placebo in treating acute mania. Carbamazepine, haloperidol, ziprasidone, cariprazine, olanzapine, quetiapine, aripiprazole, lithium, paliperidone, asenapine, and divalproex were noticeably more effective than placebo. CONCLUSIONS: Overall, tamoxifen appears to be the most effective of the currently known pharmaceutical therapy available to treat acute mania or manic episodes; however, this conclusion is restricted by the scale of RCTs conducted, and risperidone was found to be the most effective medication among antipsychotics. Carbamazepine, haloperidol, ziprasidone, cariprazine, olanzapine, quetiapine, aripiprazole, lithium, paliperidone, asenapine, and divalproex were noticeably effective in treating acute mania or manic episodes.

Subjective attitudes moderate the social connectedness in esports gaming during COVID-19 pandemic: A cross-sectional study.

Background: Electronic sports (esports) has become a practical intervention for young people craving social connections since the COVID-19 pandemic. Past studies have shown an equivocal role of esports participation in boosting social ties or social connectedness. It is unclear if their relationship is affected by subjective attitudes of gamers. Moreover, the present COVID-19 pandemic may further modify this relationship to a greater extent. Objective: This study primarily aimed to investigate the moderating effect of participants' subjective attitudes toward esports gaming on the relationship between in-game interaction during esports participation and participants' anticipated social connectedness among Chinese young adults during the COVID-19 lockdown periods in China. Methods: We conducted a nationwide online questionnaire survey through the Credamo platform among 550 Chinese young adults in the present study. The Social Connectedness Scale-Revised was used to assess participants' social connectedness levels. Results: Four hundred and fifty-three participants were included in the final analysis. The effective response rate was 82.4%. Our results showed that the esports participation measured by in-game communication frequency among participants, as an independent factor, was negatively associated with participants' social connectedness scores (ß = -0.13, p < 0.05). However, when the moderating effect of subjective attitudes toward esports gaming was considered, the association between communication frequency and social connectedness scores was turned into the opposite direction with a larger effect size (ß = 0.35, p < 0.001). Conclusion: Our primary finding revealed that a positive mindset in esports gaming is indispensable in boosting social connectedness. Overall, our study provided supporting evidence for the benefits of esports on individuals' social connectedness. In future circumstances similar to the COVID-19 era, playing esports games is strongly encouraged in an attempt to maintain social connections and relieve psychological stress. In the meantime, we believe that having a positive esports experience, often associated with a positive mindset during gaming, can better promote social connectedness. Nevertheless, the amount of time spent on gaming per day should be of great concern, as esports games can be addictive, especially for teenagers and college students.

Application of CT Medical Imaging Combined with Deep Learning 3D Reconstruction in the Diagnosis and Rehabilitation of Anterior Cruciate Ligament Injury in Table Tennis Players.

Because of the intense competition, table tennis requires players to bear a strong physiological load, which increases the risk of sports injury. Anterior cruciate ligament (ACL) is an important structure of the knee joint to maintain forward stability and rotational stability and is also a common sports injury in table tennis players. ACL has poor self-repair ability after injury. Therefore, the purpose of this study is to provide a more comprehensive, reliable, and representative theoretical basis for the diagnosis and rehabilitation of anterior cruciate ligament injury in table tennis players, and three-dimensional reconstruction of ACL using dual-source computed tomography (DSCT) combined with deep learning was conducted. For this purpose, a number of table tennis players with ACL injuries were collected, and each patient underwent arthroscopic anterior cruciate ligament reconstruction. DSCT scanning was performed on several knee joints, the 3D model of the knee joint was reconstructed using a CT image postprocessing workstation, and the medial wall of the femoral lateral condyle was reconstructed, as well as the reconstructed single tract of bony canal, tibial plateau, and bony canal. Then, the Lysholm score was used to score the cases, with scores greater than 75 as the excellent group and below 75 as the poor group. The relative positions of the central points of the femoral and tibial canals were marked and measured. The results were as follows: 3D-CT reconstruction could clearly reflect the situation after anterior cruciate ligament reconstruction. In clinic, it is used to evaluate the relationship between bone tunnel location and graft shape so as to guide the surgeon to improve the operation.

[Effects of electroacupuncture combined with passive stretch exercise on disused muscle atrophy and expression of skeletal troponin in mice].

OBJECTIVE: To observe the efficacy of electroacupuncture (EA) plus passive stretch exercise in the treatment of disused atrophy of gastrocnemius and soleus muscles in mice. METHODS: Fifty C57BL/6 mice were randomly and equally divided into 5 groups: blank control, model, passive stretch exercise (exercise), EA and EA+exercise groups. The muscular atrophy model was established by fixing the gastrocnemius and soleus muscles with plaster immobilization (by putting the right leg into a plastic vial and then twining the vial with medical plaster bandage from the ankle upwards to the thigh and groin to maintain the knee-joint flexion and ankle joint plantar flexion for 7 days). EA (2 Hz/100 Hz, 1 mA)was applied to bilateral "Zusanli"(ST36) for 10 min, once a day for 4 weeks. For mice with the passive exercise, the plastic vial was removed first, followed by pulling out the hindleg to seize the toes to stretch them until the right hindleg is fully extended, then, pushed the leg towards the body. The procedures were repeated once again and again for 10 min. The exercise was conducted once daily, for 4 weeks. The cross-sectional area of fast and slow muscle fibers of the soleus and gastrocnemius was measured under electronic microscope after ATPase histochemical stain and the expression of slow skeletal muscle troponin (TNNI1) and fast skeletal muscle troponin (TNNI2) in the soleus and gastrocnemius was detected by Western blot. RESULTS: Compared with the blank control group, the cross-sectional areas of the fast and slow muscle fibers of the soleus and gastrocnemius muscles were significantly decreased in the model group (P<0.05, P<0.01). Following the interventions, the cross-sectional areas of the fast and slow muscle fibers of soleus muscle in the EA+exercise group, and those of the fast and slow muscle fibers of the gastrocnemius muscle in the EA and EA+exercise groups, and the expression levels of TNNI1 and TNNI2 proteins in the gastrocnemius muscle of the EA+exercise group were significantly increased in comparison with the model group (P<0.05, P<0.01). CONCLUSION: EA combined with passive stretch exercise can promote the recovery of the soleus and gastrocnemius muscles in disused muscle atrophy mice, which may be related to its effect in up-regulating the expression of TNNI1 and TNNI2 proteins.