Frontiers in Medicine最新文献

{"title":"Automated lung segmentation on chest MRI in children with cystic fibrosis.","authors":"Friedemann G Ringwald, Lena Wucherpfennig, Niclas Hagen, Jonas Mücke, Sebastian Kaletta, Monika Eichinger, Mirjam Stahl, Simon M F Triphan, Patricia Leutz-Schmidt, Sonja Gestewitz, Simon Y Graeber, Hans-Ulrich Kauczor, Abdulsattar Alrajab, Jens-Peter Schenk, Olaf Sommerburg, Marcus A Mall, Petra Knaup, Mark O Wielpütz, Urs Eisenmann","doi":"10.3389/fmed.2024.1401473","DOIUrl":"https://doi.org/10.3389/fmed.2024.1401473","url":null,"abstract":"<p><strong>Introduction: </strong>Segmentation of lung structures in medical imaging is crucial for the application of automated post-processing steps on lung diseases like cystic fibrosis (CF). Recently, machine learning methods, particularly neural networks, have demonstrated remarkable improvements, often outperforming conventional segmentation methods. Nonetheless, challenges still remain when attempting to segment various imaging modalities and diseases, especially when the visual characteristics of pathologic findings significantly deviate from healthy tissue.</p><p><strong>Methods: </strong>Our study focuses on imaging of pediatric CF patients [mean age, standard deviation (7.50 ± 4.6)], utilizing deep learning-based methods for automated lung segmentation from chest magnetic resonance imaging (MRI). A total of 165 standardized annual surveillance MRI scans from 84 patients with CF were segmented using the nnU-Net framework. Patient cases represented a range of disease severities and ages. The nnU-Net was trained and evaluated on three MRI sequences (BLADE, VIBE, and HASTE), which are highly relevant for the evaluation of CF induced lung changes. We utilized 40 cases for training per sequence, and tested with 15 cases per sequence, using the Sørensen-Dice-Score, Pearson's correlation coefficient (<i>r</i>), a segmentation questionnaire, and slice-based analysis.</p><p><strong>Results: </strong>The results demonstrated a high level of segmentation performance across all sequences, with only minor differences observed in the mean Dice coefficient: BLADE (0.96 ± 0.05), VIBE (0.96 ± 0.04), and HASTE (0.95 ± 0.05). Additionally, the segmentation quality was consistent across different disease severities, patient ages, and sizes. Manual evaluation identified specific challenges, such as incomplete segmentations near the diaphragm and dorsal regions. Validation on a separate, external dataset of nine toddlers (2-24 months) demonstrated generalizability of the trained model achieving a Dice coefficient of 0.85 ± 0.03.</p><p><strong>Discussion and conclusion: </strong>Overall, our study demonstrates the feasibility and effectiveness of using nnU-Net for automated segmentation of lung halves in pediatric CF patients, showing promising directions for advanced image analysis techniques to assist in clinical decision-making and monitoring of CF lung disease progression. Despite these achievements, further improvements are needed to address specific segmentation challenges and enhance generalizability.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1401473"},"PeriodicalIF":3.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coexisting metabolic dysfunction-associated steatotic liver disease exacerbates in-hospital outcomes in patients with heat stroke.","authors":"Ping Zhang, Guo Tang, Hongguang Gao, Tianshan Zhang, Sha Yang, Tao Cheng, Rong Yao","doi":"10.3389/fmed.2024.1451133","DOIUrl":"10.3389/fmed.2024.1451133","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the impact of coexisting metabolic dysfunction-associated steatotic liver disease (MASLD) on in-hospital mortality and organ injury markers in patients with heat stroke (HS).</p><p><strong>Approach: </strong>HS patients were retrospectively identified between July 1, 2022 and September 30, 2023 at West China Hospital, Sichuan University. Baseline characteristics, such as demographics, initial vital signs, and organ functional indicators were collected. Outcome events included organ injury and in-hospital mortality. The Least Absolute Shrinkage and Selection Operator (Lasso) method was employed to identify the optimal predictors for in-hospital mortality in HS patients. Subsequently, multivariable logistic regression analysis was performed to assess the relationship between the presence of MASLD and in-hospital mortality as well as organ function indicators.</p><p><strong>Findings: </strong>A total of 112 patients were included in the study, in which 27 (24.1%) had coexisting MASLD. Compared to those without MASLD, patients with MASLD had higher levels of various organ injury markers such as aspartate aminotransferase, urea nitrogen, serum cystatin C, creatinine, uric acid, myoglobin, creatine kinase and its isoenzymes upon admission (<i>P</i> < 0.05). The multivariable Logistic regression analysis indicated that the presence of MASLD is an independent risk factor for in-hospital mortality in HS patients.</p><p><strong>Conclusion: </strong>This study firstly indicated that coexisting MASLD may exacerbate organ injury in HS patients and serve as an independent risk factor for in-hospital mortality.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1451133"},"PeriodicalIF":3.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering primary care physicians in child and adolescent psychiatry: a needs assessment on collaborative care in Dubai.","authors":"Anna Berbenyuk, Asma Alameeri, Asma Bin Ismail, Nabil Zary, Meshal A Sultan","doi":"10.3389/fmed.2024.1456212","DOIUrl":"10.3389/fmed.2024.1456212","url":null,"abstract":"<p><strong>Background: </strong>Child and adolescent psychiatric disorders pose significant public health concerns necessitating prompt intervention. Primary care physicians (PCPs) play a critical role as initial points of contact, facilitating early detection, management, and referral of these conditions. In Dubai, integrating mental health services into primary care faces unique challenges, highlighting the need for systemic reforms and enhanced PCP training.</p><p><strong>Objective: </strong>This study investigated perceptions, barriers, and systemic challenges encountered by PCPs in managing child and adolescent psychiatric conditions in Dubai's primary care setting. It also assessed family physicians' involvement and preparedness in this domain.</p><p><strong>Methods: </strong>Using a mixed-methods approach, we conducted a survey among family physicians in Dubai Health facilities and analyzed patient data from family medicine clinics. The survey evaluated formal training, preparedness, encounter frequency, and referral patterns for psychiatric care in young patients. Qualitative insights from open-ended survey questions provided additional understanding of specific challenges.</p><p><strong>Results: </strong>Findings revealed significant gaps in formal training, with only 33.3% of respondents trained in child and adolescent psychiatry during medical education, and 21.1% participating in Continuing Medical Education (CME). A majority (54.4%) of PCPs felt unprepared to manage psychiatric care in young patients. Patient data analysis showed a predominance of male patients (59.9%) and identified Autism Spectrum Disorder (43.1%) as the most common condition, emphasizing the reliance on specialized care through a high referral rate (63.1%). Major barriers included time constraints, limited psychiatric knowledge, resistance to mental health services, systemic and structural issues, communication challenges, and resource shortages.</p><p><strong>Conclusion: </strong>Enhanced training and systemic reforms are urgently needed to integrate mental health services effectively into Dubai's primary care. Implementing structured collaborative care models, fostering interdisciplinary collaboration, and addressing systemic barriers are crucial for improving child and adolescent psychiatric condition management. These initiatives promise better patient outcomes and more efficient healthcare resource utilization.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1456212"},"PeriodicalIF":3.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between serum complement 4 and relapse of primary membranous nephropathy: a multicenter retrospective cohort study.","authors":"Wenyuan Gan, Fan Zhu, Xingruo Zeng, Wei Xiao, Xun Fang, Licong Su, Wenli Chen","doi":"10.3389/fmed.2024.1451677","DOIUrl":"10.3389/fmed.2024.1451677","url":null,"abstract":"<p><strong>Background: </strong>Relapse after initial remission reduces renal survival in patients with primary membranous nephropathy (PMN). In this study, we aim to identify risk factors of relapse in PMN and construct a model to identify patients at high risk of relapse early.</p><p><strong>Methods: </strong>We conducted a multi-center retrospective study using the China Renal Data System database, which includes data from 24 urban academic centers across China. A prediction model based on the Cox proportional hazards model was derived in the derivation group and validated in the validation group.</p><p><strong>Result: </strong>515 patients with biopsy-proven PMN achieving initial remission were enrolled. 32.62% of patients subsequently relapsed during a median of 6.08 months. Lower serum albumin (Alb) (per 1 g/L decrease, hazard ratio [HR] =1.48, 95% confidence interval [CI] 1.29-1.78, <i>p</i> < 0.001), lower estimated glomerular filtration rate (eGFR) (per 10 mL/min/1.73m² decrease, HR =1.14, 95% CI 0.97-1.49, <i>p</i> < 0.001), higher serum complement 4 (C4) (per 0.1 g/L increase, HR =1.89, 95% CI 1.32-3.22, <i>p</i> = 0.012), partial remission (PR) (HR =2.28, 95%CI 1.74-4.04, <i>p</i> < 0.001), and treatment with calcineurin inhibitors (CINs) (HR =1.33, 95%CI 1.04-1.64, <i>p</i> < 0.001) at the time of remission were risk factors for relapse. C-statistic, time-dependent areas under the receiver operating characteristic curve, and calibration plots confirmed that the model had excellent discrimination and calibration in predicting PMN relapse. The anti-phospholipase A2 receptor antibody (aPLA2Rab) titers and pathologic features did not substantially improve the model.</p><p><strong>Conclusion: </strong>Our study confirms the well-known low Alb and eGFR, PR, and treatment of CNIs at the time of remission as risk factors for PMN relapse, but aPLA2Rab and pathologic features may not predict relapse. In addition, it is the first study to show serum C4 is associated with PMN relapse. We suggest that complement-targeted therapies may be a potential therapy to prevent PMN relapse.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1451677"},"PeriodicalIF":3.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: A case of blood culture-negative <i>Bartonella quintana</i> endocarditis: blood mNGS is an efficient method for early diagnosis.","authors":"Jun-Fan Pu, Yan-Ling Zhou, Min Deng, Jing Wu","doi":"10.3389/fmed.2024.1449637","DOIUrl":"10.3389/fmed.2024.1449637","url":null,"abstract":"<p><p><i>Bartonella quintana</i> is one of the main causes of blood culture-negative endocarditis, and routine blood culture and serological methods are difficult to achieve early diagnosis. We report a case of blood culture-negative <i>Bartonella quintana</i> endocarditis from southwestern Chongqing. The patient was a 67-year-old male scavenger who presented with heart failure without fever as the main clinical manifestation upon admission. He stated having had contact with stray cats in the past 2 months. The combination of clinical symptoms, echocardiography, and blood mNGS testing confirmed the infection of <i>Bartonella quintana</i>.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1449637"},"PeriodicalIF":3.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic kidney disease and its associated factors in HIV-infected individuals: a comparison of antiretroviral therapy naïve and experienced patients.","authors":"Daniel Asmelash, Marye Nigatie","doi":"10.3389/fmed.2024.1455688","DOIUrl":"10.3389/fmed.2024.1455688","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) has emerged as one of the primary comorbidity affecting individuals infected with human immunodeficiency virus (HIV), even after the initiation of highly active antiretroviral therapy (HAART). The main objective of this study was to assess the prevalence of CKD and its associated factors among HIV-infected individuals who are HAART naïve compared to those who are HAART experienced.</p><p><strong>Methods: </strong>An institution-based cross-sectional study was conducted at Mizan Tepi University Comprehensive Specialized Hospital from March to May 2022. A double population proportion formula was used to select 250 study participants, with 125 being HAART naïve and 125 being HAART experienced. Socio-demographic and clinical data were collected using a semi-structured questionnaire. Serum creatinine levels were measured using a Mindray BS-200 chemistry analyzer, and the estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) equation. The level of urine protein was measured using a reagent strip within 30 min of collection. Descriptive statistics, independent t-tests, and multivariable logistic regression analysis were performed, with a <i>p</i>-value of <0.05 considered statistically significant.</p><p><strong>Result: </strong>The mean (±SD) age of the HAART-naïve individuals was 35 ± 9.5, while that of the HAART-experienced individuals was 45 ± 9.9 years. Of the total participants, 67.2% participants were women. The overall prevalence of CKD among the HIV-infected study participants was 36.4%. The prevalence of CKD was 33.6% in HAART-naïve individuals and 39.2% in HAART-experienced individuals, with a <i>p</i>-value of 0.03. Male sex was identified as an independent factor associated with CKD in this study.</p><p><strong>Conclusion: </strong>The prevalence of CKD was found to be higher among HAART-experienced individuals than HAART-naïve individuals. Regular renal function assessments should be conducted before and during HAART to mitigate the risk of renal dysfunction.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1455688"},"PeriodicalIF":3.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior mediastinal extralobar pulmonary sequestration in a neonate with pulmonary artery supply: a case report.","authors":"Kaiyi Mao, Leibo Wang, Yuchen Mao, Xianhui Shang, Guangxu Zhou, Peng Zhao, Cao Wang, Hong Ma","doi":"10.3389/fmed.2024.1455978","DOIUrl":"10.3389/fmed.2024.1455978","url":null,"abstract":"<p><p>This paper reports a rare case of extralobar pulmonary sequestration in the posterior mediastinum of a neonate with arterial supply from the pulmonary artery. A 3-day-old male neonate was diagnosed with type II congenital pulmonary airway malformation after prenatal color Doppler ultrasonography showed a lesion with blood supply from the pulmonary artery in the left lung. Post-birth chest computed tomography(CT) showed that the lesion was located in the posterior mediastinum with low density change, mild stripe enhancement after contrast, and no obvious blood supply vessels. A neurogenic tumor was considered for the preoperative diagnosis. The mass was removed by video-assisted thoracoscopic surgery. During the surgery, the mass was observed to be a dark red solid lump with a feeding vessel originating from the pulmonary artery. The postoperative histopathological diagnosis was extralobar pulmonary sequestration. Combined with the preoperative imaging results, it was considered that the nourishing vessels might have intermittent torsion. The patient recovered well after surgery, and no recurrence was observed after 6 months of follow-up. Therefore, the possibility of extralobar pulmonary sequestration cannot be ruled out for posterior mediastinal masses that are not supplied by the descending aorta or without identified feeding vessels.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1455978"},"PeriodicalIF":3.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound combined with DSA-guided pulsed radiofrequency for perineal herpes zoster pain management: clinical outcomes and complications.","authors":"Qing-Peng Dong, Shao-Jun Li","doi":"10.3389/fmed.2024.1442199","DOIUrl":"10.3389/fmed.2024.1442199","url":null,"abstract":"<p><strong>Background: </strong>Herpes zoster (HZ) in the perineal area is a rare disease. There are limited treatment options for this disease. This study aimed to assess the efficacy of ultrasound combined with digital subtraction angiography (DSA)-guided pulsed radiofrequency (PRF) for perineal herpes zoster-related pain.</p><p><strong>Methods: </strong>Two hundred and twelve patients with perineal HZ were enrolled at the pain department. From January 1, 2018 to December 30, 2019, patients with HZ in the perineal area were treated with PRF under DSA guidance, and from January 1, 2020 to October 30, 2023, patients with HZ in the perineal area were treated with PRF under ultrasound combined with DSA guidance. The included patients were divided into two groups: DSA group and ultrasound + DSA group. The visual analog scale (VAS), central sensitization inventory (CSI), sleep quality scores (SQS), the 36-Item Short Form Health Survey questionnaire (SF-36) at baseline and after the PRF treatment were analyzed to evaluate clinical efficacy.</p><p><strong>Results: </strong>The mean VAS scores, CSI scores, SQS, and SF-36 scores were statistically significantly lower after treatment compared to baseline (<i>p</i> < 0.001). There was no significant change in VAS scores, CSI scores, SQS, and SF-36 scores between the DSA group and the ultrasound + DSA group (<i>p</i> > 0.05). The time it took from the start of the puncture to the successful puncture was significantly shorter in the ultrasound + DSA group compared to the DSA group (41.2 ± 21.2 vs. 48.1 ± 20.3, <i>p</i> = 0.035). The ultrasound + DSA group had a higher percentage of satisfaction with the procedure than the DSA group (90/99, 90.9% vs. 62/78, 79.5%, <i>p</i> = 0.030). A total of 27 postoperative complications occurred. The incidence of puncture site hematoma was significantly higher in the DSA group (10/78, 12.8%) than that in the ultrasound + DSA group (4/99, 4.0%) (<i>p</i> = 0.032).</p><p><strong>Conclusion: </strong>PRF can reduce pain from HZ in the perineal region, alleviate central sensitization, enhance sleep quality, and improve overall quality of life. When PRF is performed under ultrasound guidance combined with DSA, it shortens the puncture time and reduces the risk of hematoma formation at the puncture site, making it the recommended method for clinical use.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1442199"},"PeriodicalIF":3.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of traditional Chinese Yijinjing exercise on hand dysfunction in rheumatoid arthritis patients: a randomized controlled trial.","authors":"Tian Chang, Xieli Ma, Xun Gong, Congmin Xia, Quan Jiang, Rouman Zhang","doi":"10.3389/fmed.2024.1454982","DOIUrl":"10.3389/fmed.2024.1454982","url":null,"abstract":"<p><strong>Introduction: </strong>Rheumatoid arthritis (RA) patients often experience significant hand dysfunction. Yijinjing, a traditional Chinese exercise, has been recognized for its benefits to mind-body health. This study aimed to evaluate the efficacy and safety of Yijinjing in improving hand dysfunction among individuals with RA.</p><p><strong>Methods: </strong>This research was conducted as a single-center, outcome-blinded, randomized controlled trial. A total of 66 eligible RA participants were randomly assigned in a 1:1 ratio to either the Yijinjing exercise group (YJJG) with sessions conducted three times per week over a 12-week period or the control group (CG), which maintained ordinary activities. Various outcomes were assessed, including the Michigan Hand Outcomes Questionnaire (MHQ), handgrip strength, active range of motion (AROM), RA disease activity, the Health Assessment Questionnaire Disability Index (HAQ-DI), levels of anxiety and depression, and wrist ultrasound, all of which were collected at baseline and the week 12.</p><p><strong>Results: </strong>At the end of the 12 weeks, the YJJG demonstrated significant improvements in MHQ scores compared to the CG (<i>p</i> < 0.05), alongside enhancements in handgrip strength and AROM, specifically in wrist extension, radial deviation, and metacarpophalangeal flexion (<i>p</i> < 0.05). Wrist ultrasound scores did not exhibit a significant increase in the YJJG, meaning no inflammation aggravation (<i>p</i> > 0.05). Additionally, morning stiffness duration, Disease Activity Score 28-ESR (DAS28-ESR), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels showed significant improvement in the YJJG (<i>p</i> < 0.05). Both groups reported enhancements in quality of life, as well as reductions in anxiety and depression scores, with the YJJG displaying greater improvements overall (<i>p</i> < 0.05). Importantly, no adverse events or significant abnormalities in vital signs were observed in either group.</p><p><strong>Conclusion: </strong>Yijinjing exercise may effectively enhance hand function, handgrip strength, and flexibility in RA patients with low disease activity. Furthermore, it appears to improve quality of life and reduce anxiety and depression without exacerbating joint inflammation.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT05527158, Identifier NCT05527158.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1454982"},"PeriodicalIF":3.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scientific landscape of oxidative stress in sarcopenia: from bibliometric analysis to hotspots review.","authors":"Linjie Wang, Dongliang Guo, Yi Huang, Pan Long, Xin Zhang, Ling Bai, Jiancheng Liu, Xiaomin Hu, Rizhao Pang, Xiang Gou","doi":"10.3389/fmed.2024.1472413","DOIUrl":"10.3389/fmed.2024.1472413","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Sarcopenia is a significant healthcare challenge in the aging population. Oxidative stress (OS) is acknowledged to play a pivotal role in the pathological progression of sarcopenia. Numerous studies have demonstrated that mitigating or eliminating OS can ameliorate the pathological manifestations associated with sarcopenia. However, current clinical antioxidant therapies often fall short of anticipated outcomes. This bibliometric analysis aims to delineate prevailing research trends, thematic emphases, focal points, and developmental trajectories within the domain of OS in sarcopenia, while also endeavoring to explore prospective anti-oxidative stress strategies for future clinical interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Relevant publications were retrieved from the Web of Science (WOS) Core Collection database for the period 2000-2024. Citespace was employed for retrieving and analyzing trends and emerging topics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the field of OS in sarcopenia, the number of publications has significantly increased from 2000 to 2024. The United States and China are the primary contributors to global publication output. The most productive research institution is INRAE. The most prolific author is Holly Van Remmen from the United States, while the most frequently cited author is Cruz-Jentoft AJ from Spain. Experimental Gerontology is the journal with the highest volume of published articles, whereas the Journal of Gerontology Series A: Biological Sciences and Medical Sciences holds the record for the highest number of citations. The research keywords in this field can be categorized into eight domains: \"Physiology and anatomy\", \"Physiological mechanisms\", \"Pathology associations\", \"Experimental studies\", \"Nutrition and metabolism\", \"Sports and physical activities\", \"Age\" and \"Oxidation and antioxidation\". Moreover, recent years have seen the emergence of \"TNF-&lt;i&gt;α&lt;/i&gt;,\" \"insulin resistance\", \"mitochondrial autophagy\", \"signal pathways\", and \"mechanisms\" as focal points in the realm of OS in sarcopenia, encompassing related fundamental research and clinical translation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This bibliometric and visualization provides a comprehensive analysis of the global research landscape in the field of OS in sarcopenia, identifies priorities, summarizes the current research status and suggests possible future research priorities. In addition, in order to benefit more sarcopenia patients, strengthening cooperation and communication between institutions and research teams is the key to the future development of this field. Given the expectation that research on OS in sarcopenia will remain a prominent area of interest in the future, this article could serve as a valuable resource for scholars seeking to shape future studies through an understanding of influential scholarly contributions and key research findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Systematic review registration: &lt;/strong&gt;https://","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1472413"},"PeriodicalIF":3.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}