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Aims: This study aimed to systematically evaluate the effectiveness of patient decision aids on knowledge, decisional conflict and decisional self‐efficacy outcomes in patients with diabetes. Methods: A comprehensive database search was performed using the Web of Science, Cochrane Library, PubMed, Embase, PsycINFO (Ovid), CINAHL (EBASCO), CNKI, VIP, Wan Fang Database and the Ottawa Decision Aid Library Inventory (http://decisionaid.ohri.ca/index.html) from inception to 13 October 2019. Two reviewers independently searched databases, screened articles, extracted data and evaluated the risk bias of included studies. Then Rev Man 5.3 software was adopted for statistical analysis. Results: Ten articles containing 1,452 people with diabetes were selected. The results of meta‐analysis showed that patient decision aids had a positive effect on reducing decisional conflict and improving decisional self‐efficacy among patients with type 2 diabetes. Meanwhile, this article also revealed that patient decision aids have beneficial short‐term effects on improving knowledge, but there was no significant long‐term effect. Conclusion: Patient decision aids are capable of becoming support tools to improve shared decision making. Further implementation studies are required to transform patient decision aids tools into clinical practice. SUMMARY STATEMENT: What is already known about this topic? Some patient decision aids have been reported to support patients with diabetes' information processing and decision making.The application of patient decision aids can narrow the knowledge gap between patients and doctors so as to facilitate patient activation. What this paper adds? This article extends the evidence on the beneficial effects of patient decision aids on reducing decisional conflict, improving self‐efficacy and knowledge level among patients with type 2 diabetes mellitus.The review recommends patient decision aids as a supplementary method to promote the quality and effectiveness of decision making for patients with diabetes. The implications of this paper Clinicians could incorporate patient decision aids as part of their clinical consultation, being fully considerate of the patient's preferences. [ABSTRACT FROM AUTHOR]

Background: The effect of dietary advice on malnutrition in cancer patients is unclear. The aim of this systematic review was to evaluate the effects of dietary advice in cancer patients who were malnourished or at risk of malnutrition.Methods: Seven electronic databases were searched for randomized controlled trials (RCTs) of dietary counseling intervention in cancer patients with malnutrition or at risk of malnutrition. The studies were selected according to the inclusion and exclusion criteria and were critically appraised and abstracted by two researchers individually. Effect sizes were presented as weighted mean differences (WMD) or risk ratio (RR) with 95% confidence intervals (95%CI).Results: Six RCTs (737 participants) were included in meta-analysis. Comparing to usual care, dietary advice given by dieticians could not reduce mortality (RR = 1.11, 95%CI = 0.95 to 1.29) and body weight (WMD = 4.28 kg, 95%CI = - 0.21 to 8.76 kg) in cancer patients who were malnourished or at risk of malnutrition, but it was associated with statistically significant improvements in energy intake (WMD = 230.23kCal, 95%CI: 171.49 to 288.98), and quality of life (WMD = 37.92, 95%CI: 23.14 to 52.70).Conclusions: There remains insufficient evidence to conclude the actual effect of dietary advice given by dieticians in malnourished patients with cancer. Meta-analysis suggested that dietary advice given by dietitians may have no effect on mortality and body weight in patients with cancer who are malnourished, but it may be effective for improving QoL and energy intake. Studies with adequate participants and a clear low risk of bias are required to improve accuracy and confidence of conclusions. [ABSTRACT FROM AUTHOR]

Abstract The resonance enhanced multiphoton ionization (REMPI), ultraviolet-ultraviolet (UV-UV) hole burning and mass analyzed threshold ionization (MATI) spectroscopy have been applied to investigate the vibrational features of p ‑isopropylphenol in its first electronically excited state S 1 and cationic ground state D 0. Two stable conformational structures of p ‑isopropylphenol are distinctly found in the supersonic molecular beam and identified as the cis and trans rotamers through REMPI and UV-UV hole burning spectroscopy. The electronic excitation energies of S 1 ← S 0 transition of two rotamers are determined to be 35,578 and 35,593 cm−1, and the adiabatic ionization energies are 65,331 and 65,350 cm−1, respectively. The MATI spectra recorded via different intermediate levels of S 1 state indicate the similarity in the molecular geometry between the S 1 state and the D 0 state for each rotamer of p ‑isopropylphenol. Geometrical optimizations of p ‑isopropylphenol have also been performed using the density functional theory (DFT) for S 0 and D 0 states, and time-dependent density functional theory (TDDFT) for S 1 state. The simulated spectra for S 1 ← S 0 and D 0 ← S 1 transitions of two rotamers are able to reproduce qualitatively the experimental spectral profile, which help us to assign the vibronic modes. Most of the observed vibrations of two rotamers in the S 1 and D 0 states are related to the in-plane ring deformation and some active modes involving isopropyl group. Graphical Abstract Unlabelled Image Highlights • Two rotamers of p ‑isopropylphenol coexist in a supersonic molecular beam. • Precise excitation energies and ionization energies of two rotamers were determined. • Hole-burning and mass analyzed threshold ionization experiments were performed. • Vibronic spectra of two rotamers in excited state S 1 were observed and assigned. • Cationic vibrationic features of two rotamers were analyzed and assigned. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • 2C REMPI and MATI spectra of 4-fluorobenzonitrile are obtained. • Vibronic spectra of 4-fluorobenzonitrile in S 1 state are analyzed and assigned. • Cationic vibrationic features of 4-fluorobenzonitrile are analyzed and assigned. • Most of the active vibrations are related to the in-plane ring deformation. Abstract The vibrational features of 4-fluorobenzonitrile in the first electronically excited state S 1 and cationic ground state D 0 have been studied by two-color resonance enhanced multiphoton ionization and mass analyzed threshold ionization spectroscopy. Most of observed vibrations in the S 1 and D 0 states are related to in-plane ring deformation and CN bending motions. The band origin of the S 1 ← S 0 transition and adiabatic ionization energy of 4-fluorobenzonitrile are determined to be 36,616 ± 2 and 78,000 ± 5 cm−1, respectively. These data provide insight into the substitution effect of fluorine atom and cyano group on the transition energy. [ABSTRACT FROM AUTHOR]

Two-color resonance two-photon ionization and mass analyzed threshold ionization spectra of 2-aminobenzonitrile have been obtained. The band origin of the S 1  ←  S 0 transition and the precise ionization energy (IE) were determined to be 31,265 ± 2 cm −1 and 66,653 ± 5 cm −1 , respectively. The most active modes in the S 1 and D 0 states are related to the in-plane ring vibrations. The relative errors of IE estimated by CBS-QB3 and G4 are −0.18% and +1.47%, respectively. The theoretical calculations well support our experimental findings. [ABSTRACT FROM AUTHOR]

Background: Medical decision-making is a complex multi-stage process. Chinese cancer patients' preference for participation in decision-making stages, family involvement and influencing factors remain unclear. Methods: A total of 1,422 cancer patients from four tertiary hospitals in China were included in the cross-sectional survey. Patient Expectation for Participation in Medical Decision-making Scale was used to measure patients' information, deliberation and decisional control preferences. The patient-family Control Preferences Scale was used to measure expected and actual levels of family involvement. Generalized estimation equation was performed to explore factors associated with patients' preferences. Results: 93.0% of patients had a high preference for information exchange, 95.8% for treatment deliberation, and 61.7% for decisional control. Equal participation was most common in family involvement in decision-making, followed by family-led and patient-led. 15.5% of patients reported a discrepancy between expected and actual family involvement. Age, education, marital status, number of adult children, occupation, family income, regular residence, health insurance and time since diagnosis were related to patient preference. Compared to patients with other cancer sites, those with breast [odds ratio (OR) 2.02, 95%CI: 1.47–2.77] and thyroid cancer [OR 2.37, 95%CI: 1.82–3.10] had higher information preference, those with breast [OR 2.98, 95%CI: 2.73–3.26] and esophagus cancer [OR 2.86, 95%CI: 1.13–7.22] had higher deliberation preference, and thyroid cancer patients [OR 1.50, 95%CI: 1.07–2.10] had higher decisional control preference. Patients who expected or experienced equal participation had higher preference at all stages of decision-making than those with family-led involvement. Patients with inconsistent expected and actual family involvement had lower preferences for the deliberation [OR 0.53, 95%CI: 0.36–0.77] and decisional control stages [OR 0.67, 95%CI: 0.56–0.79]. Conclusions: Chinese cancer patients generally have high preference for information exchange and treatment deliberation, but varied preferences for decision control, influenced by patients' sociodemographic factors, cancer types, time since diagnosis and family involvement. The findings underscore the importance of tailoring medical decision-making processes to individual patient preferences and ensuring family involvement aligns with patient expectations to enhance patient-centered care in China. [ABSTRACT FROM AUTHOR]

Objectives: To ascertain the effects of prolonging flushing intervals (FIs) for Totally Implantable Venous Access Devices (TIVADs) on catheter-related complications in the off-treatment period. Methods: A preliminary search of PubMed, EMBASE, Cochrane, Web of Science, Web of Science, Scopus, CNKI, and SinoMed was conducted from inception to 6th June 2023, using the keywords "vascular access devices", "interval", "occlusion", and "complication". Two independent reviewers performed studies screening, quality assessment, and data extraction. The methodological quality of included articles was assessed using the Newcastle–Ottawa Scale (NOS) and Risk of Bias (ROB) tools. Meta-analysis and trial sequential analysis (TSA) was performed to calculate the risk ratios and 95% confidence interval (CI). Results: Eleven studies with 4,924 participants were included. Extending FIs to two or three months increased the risk of catheter occlusion compared to one-month intervals [RR = 1.50 (1.18–1.92), P = 0.001], but this finding was not confirmed by sensitivity analysis and TSA. Extending FIs to three months showed no significant effect on overall complications rates [RR = 1.21 (0.99–1.48), P = 0.49], consistent with sensitivity analysis and TSA results. For other catheter-related complications, the results showed extending the FIs to three months was feasible, but with weak measurements due to insufficient data. Conclusion: Data from the current included studies tended to support the feasibility of extending the flushing interval to every three months, with no expected increase in catheter occlusion or overall catheter complications. However, due to the inherent limitations of the included study, the findings of the current study should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Concrete box subgrades constructed from reinforced concrete serve as alternatives to conventional fill subgrades, effectively addressing the scarcity of high-quality fill materials. A hybrid simulation approach that merges coupled dynamics with finite element modelling was adopted for both single-line and double-line ballastless track-box subgrade systems, enabling a comparative analysis of dynamic stress, displacement, and acceleration. The results reveal that, when the two traffic conditions are compared, the dynamic response of the concrete box subgrade under double-line opposing operation shows a marked increase, particularly when the dynamic displacement increases by 80%. Under opposing traffic conditions, the dynamic stress on the subgrade surface exhibits a "saddle" distribution. Vertically, the dynamic stress inversely increases within the roof and rapidly attenuates in the vertical web and floor, with reductions reaching 92.7% at the floor bottom, demonstrating the substantial capacity of the concrete box subgrade to disperse train loads. The peak dynamic displacements recorded at the subgrade surface are 0.178 mm for single-line traffic and 0.320 mm for opposing operations, indicating minimal overall vertical deformation of the concrete box subgrade. Notably, the dynamic displacement on the subgrade surface results primarily from the underlying weak subsoil. Vertical acceleration attenuation occurs predominantly within the vertical web depth, with attenuation rates exceeding 95%. The environmental vibrations induced by high-speed trains predominantly affect the area within 0 to 4 m from the edge of the subgrade floor. [ABSTRACT FROM AUTHOR]

• 2C REMPI and MATI spectra of 2-methoxybenzonitrile are obtained. • Vibronic spectra of 2-methoxybenzonitrile in S 1 state are analyzed and assigned. • Cationic vibrationic features of 2-methoxybenzonitrile are analyzed and assigned. • Only one rotamer of 2-methoxybenzonitrile is observed in the supersonic beam. • Most of the active vibrations are related to the in-plane ring deformation. We report the two-color resonance enhanced two-photon ionization (R2PI) and mass analyzed threshold ionization (MATI) spectra of 2-methoxybenzonitrile. The origin band of S 1 ← S 0 transition and accurate adiabatic ionization energy of 2-methoxybenzonitrile are determined to be 34,176 ± 2, and 70,658 ± 5 cm−1, respectively. The Franck-Condon simulations of the vibrationally resolved electronic spectra for S 1 ← S 0 and D 0 ← S 1 transitions are calculated and used to assist the assignments of the vibronic bands in the experimental spectra. The active vibrations in the S 1 and D 0 states are mainly associated with the motions of the in-plane ring deformation and the in-plane ring-OCH 3 bending. A propensity rule of Δ υ = 0 , observed in the MATI spectra recorded via different intermediate states, suggests that the molecular geometry of 2-methoxybenzonitrile in the D 0 state resembles that in the S 1 state. Comparing the transition energies of 2-methoxybenzonitrile with those of anisole, benzonitrile and ortho substituted derivatives provides insight into the substitution effect of CN and OCH 3 groups on the transition energies. [ABSTRACT FROM AUTHOR]

Objective: Clinical practice guidelines (CPGs) for Integrated Traditional Chinese and Western Medicine (TCM and WM) are important medical documents used to assist medical decision‐making and are of great significance for standardizing clinical pathways. However, due to the constraints of text format, it is difficult for Integrated TCM and WM CPGs to play a real role in medical practice. In addition, how to standardize the structure and semantic relationships between Integrated TCM and WM CPG knowledge, and realize the construction of computable, sharable and reliable CPGs, remains an urgent issue to be addressed. Therefore, we are proposing an ontology of CPGs for Integrated TCM and WM. Methods: We first initialized domain concepts and relationships to ensure the accuracy of the ontology knowledge structure. We then screened CPGs that meet the standards for Integrated TCM and WM, analyzed and classified the contents, and extracted the common structures. Based on the seven‐step ontology construction method combined with inference‐complement, referring to the representation methods and hierarchical relationships of terms and concepts in MeSH, ICD‐10, SNOMED‐CT, and other ontologies and terminology sets, we formed the concept structure and semantic relationship tables for the ontology. We also achieved the matching and mapping between the ontology and reference ontologies and term sets. Next, we defined the aspects and constraints of properties, selected multiple Integrated TCM and WM CPGs as instances to populate, and used ontology reasoning tools and formulated defined inference rules to reason and extend the ontology. Finally, we evaluated the performance of the ontology. Results: The content of the Integrated TCM and WM CPGs is divided into nine parts: basic information, background, development method, clinical question, recommendation, evidence, conclusion, result, and reason for recommendations. The Integrated TCM and WM CPG ontology has 152 classes and defines 90 object properties and 114 data properties, with a maximum classification depth of 4 layers. The terms of disease, drug and examination item names in the ontology have been standardized. Conclusions: This study proposes an Integrated TCM and WM CPG ontology. The ontology adopts a modular design, which has both sharing and scaling ability, and can express rich guideline knowledge. It provides important support for the semantic processing and computational application of guideline documents. [ABSTRACT FROM AUTHOR]

Aim: We aimed to evaluate the quality of clinical practice guidelines (CPGs) for breast cancer related lymphoedema (BCRL) and compare the similarities and differences in recommendations. Background: Many CPGs of BCRL have been developed; however, their recommendations and quality are controversial. Methods: Relevant papers were retrieved from electronic databases, professional associations and guideline development organizations, from 1 January 2015 to 30 September 2021. The Appraisal of Guidelines Research and Evaluation (AGREE) II instrument was used to evaluate the quality of the guidelines. Intraclass correlation coefficient (ICC) analysis was used to evaluate the overall consistency among evaluators. Results: Eight CPGs were included. The ICC values evaluation for CPGs ranged from 0.76 to 0.95, with good consensus among evaluators. The highest median score was 68.75% (61.46, 72.22%) for clarity, and the lowest was 37.50% (25.78, 51.30%) for applicability. The NICE, ACS/ACSO and APTA CPGs were rated well in most areas. Professional health education, individualized exercise programme and regular surveillance are the main methods to prevent lymphoedema. Conclusion: In the past 6 years, the quality of BCRL guidelines has varied greatly, especially in the domains of rigour and applicability. Interrater agreement was excellent, but recommendation showed some inconsistencies in the details. Summary statement: What is already known about this topic? Providing recommendations based on evidence‐based guidelines for care of cancer treatment‐related lymphoedema will help to improve outcomes for patients with this chronic condition. What this paper adds? The rigour of the guidelines needs to be improved.Guideline‐making organizations have the responsibility to promote the application of guidelines into practice using a variety of methods.Multifactorial reasons were responsible for the differences inguidelines' recommendations The implications of this paper Nurses need to be more aware of guideline recommendations.There are inconsistencies in the details, despite many similarities.The formulation of individual nursing care programmes should be tailored to the local clinical situation and working environment. [ABSTRACT FROM AUTHOR]

Objective: Musculoskeletal pain is having growing impacts worldwide with clinical challenge in pain management. The purpose of the present study is to investigate the preferences of orthopedic surgeons of China for using medicine in musculoskeletal pain. Methods: A questionnaire was developed, including the following domains, personal information, medication preference for pain treatment, and perceptions of topical medicine. Ten participants were selected to confirm the consistency of questionnaire. A cross‐sectional survey was conducted in orthopedic physicians with different specialties in different regions of China via the online survey platform. The participants' survey results were analyzed one‐way and multi‐way using chi‐square test and logistic regression. Results: The pre‐survey analysis results of 10 randomly selected investigators were a mean weighted kappa coefficient of 0.76 (range 0.61–0.89), which indicated the substantial consistency of the present questionnaire. A total of 1099 orthopedic surgeons (mean age, 41.67 ± 8.31 years) responded to our survey, most of whom were male (90.72%), and most of whom worked in level III hospitals (63.24%) and trained in modern medicine (71.43%). Most surgeons who participated in the survey had used topical analgesics in their clinical work (95.81%), and most preferred to use topical analgesics (39.50%) or a combination of oral analgesics (28.87%). Primary reasons for preferring topical analgesics were as follows: less adverse reactions (68.01%); ease of use (60.90%); and not interfering with other oral medications (49.60%). The preference for prescribing topical analgesics increased with the education level of the respondent, where statistically significant differences were seen (P < 0.05). In addition, the level of the respondent's hospital, type of hospital, the respondent's profession, and their participation in surgical work influenced their preferences for topical analgesics (P < 0.05). Conclusion: Orthopedic surgeons across China have different medication preferences in the treatment of musculoskeletal pain. The educational background of the physician largely influences the preference when selecting medications. To better improve the treatment of musculoskeletal pain, there is a need to improve the overall medical education of practitioners and to disseminate clinical practice guidelines. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the extension of the RIGHT Statement for INTroductions and INTerpretations of Clinical Practice Guidelines (RIGHT for INT) is to promote the development of comprehensive and clear articles that introduce and interpret clinical practice guidelines. Methods: The RIGHT for INT checklist was developed following methods recommended by the EQUATOR Network. The development process included three stages. In the first stage, a multidisciplinary team of experts was recruited by email and WeChat and further divided into three groups (a steering group, a consensus group, and a secretariat group); in the second stage, the initial items were collected by literature review and brainstorming; and in the third stage, the final items were formed through a Delphi survey and expert consultation. Results: A total of 40 initial items were collected through literature review and brainstorming. A final checklist of 27 items was formed after the Delphi survey and expert consultation. The RIGHT for INT checklist contains items on the following 10 topics: title, abstract, background of guideline interpretation, background of guideline development, guideline development methodology, recommendations, strengths, and limitations, implications for local guidelines and clinical research, dissemination and implementation, and reporting quality. Conclusion: The RIGHT for INT checklist provides guidance for guideline interpreters on how to introduce and interpret clinical practice guidelines in a scientific and comprehensive manner. [ABSTRACT FROM AUTHOR]

It has been over 20 years since the introduction of evidence‐based medicine (EBM) into the research of traditional Chinese medicine (TCM). The development of evidence‐based TCM research has profoundly influenced the process of clinical research and decision‐making, impelling researchers to pay attention to raise evidence quality, accumulate data, and explore appropriate evaluation methods adaptive to TCM original theories and knowledge. In this paper, the authors aim to summarize and review the existing work and seek promising research interests in this field, expecting to inspire more thoughts leading to breakthroughs in the near future. [ABSTRACT FROM AUTHOR]

Aim: To appraise the quality of current nursing clinical practice guidelines (N‐CPGs) in China and explore the methodology for N‐CPGs development. Background: Implementation of quality improvement projects based on N‐CPGs has becoming an hot topic for nursing with proliferation in the number of N‐CPGs in China in recent years. The methodology for developing N‐CPGs is worthy of exploration. Methods: A systematic literature search was performed using PubMed, CINAHL, Web of Science, CNKI, Wanfang, VIP and CBM and relevant representative guidelines repositories from inception to July 31, 2019. Two authors independently selected eligible guidelines and performed data extraction. Four appraisers independently assessed the quality of the N‐CPGs using the AGREE II tool. Results: 20 N‐CPGs were eventually included in this review. After AGREE II appraisal, the final domain scores ranged between 0.00 and 83.33%. When comparing the total domain scores, "Scope and purpose" and "Clarity of presentation" scored highest with a total of 63.89 (59.37–69.79) (%, median, interquartile range (IQR)), and 63.89 (58.33–75.70) (%), respectively. "Editorial independence" obtained the lowest ranking with a total score of 0 (0–81.25) (%). The total scores of "Stakeholder involvement", "Rigour of development", "applicability" and "editorial independence" were lower than 50%. Conclusion: The quality of N‐CPGs in China is not very high and the process of guideline development still needs to improve. Implications for Nursing Management: N‐CPGs are important documents used to guide nursing quality improvement. High quality N‐CPGs are beneficial for nursing management. [ABSTRACT FROM AUTHOR]

Background: Bladder cancer (BC) has become a major worldwide public health issue, especially non-muscle-invasive bladder cancer (NMIBC). A flood of related clinical practice guidelines (CPGs) have emerged; however, the quality and recommendations of the guidelines are controversial. We aimed to appraise the quality of the CPGs for NMIBC within the past 5 years and compare the similarities and differences between recommendations for therapies.Methods: A systematic search to identify CPGs for NMIBC was performed using electronic databases (including PubMed, Embase, Web of Science), guideline development organizations, and professional societies from January 12, 2014 to January 12, 2019. The Appraisal of Guidelines Research & Evaluation (AGREE) II instrument was used to evaluate the quality of the guidelines. Intraclass correlation coefficient (ICC) analysis was performed to assess the overall agreement among reviewers.Results: Nine CPGs were included. The overall agreement among reviewers was excellent. The interquartile range (IQR) of scores for each domain were as follows: scope and purpose 69.44% (35.42, 85.42%); stakeholder involvement 41.67% (30.56, 75.00%); rigour of development 48.96% (27.08, 65.63%); clarity and presentation 80.56% (75.00, 86.11%); applicability 34.38% (22.92, 40.63%) and editorial independence 70.83% (35.42, 85.42%). The NICE, AUA, EAU and CRHA/CPAM clinical practice guidelines consistently scored well in most domains. It was generally accepted that the transurethral resection of bladder tumour (TURBT) and intravesical chemotherapy should be performed in the management of bladder cancer. The application of chemotherapy was highly controversial in high risk NMIBC. The courses of BCG maintenance were similar and included 3 years of therapy at full maintenance doses.Conclusions: The quality of NMIBC guidelines within the past 5 years varied, especially regarding stakeholders, rigour and applicability. Despite many similarities, the recommendations had some inconsistencies in the details. [ABSTRACT FROM AUTHOR]

Summary Mechanical force is needed to mediate endocytosis. Whether actin, the most abundant force-generating molecule, is essential for endocytosis is highly controversial in mammalian cells, particularly synapses, likely due to the use of actin blockers, the efficiency and specificity of which are often unclear in the studied cell. Here we addressed this issue using a knockout approach combined with measurements of membrane capacitance and fission pore conductance, imaging of vesicular protein endocytosis, and electron microscopy. We found that two actin isoforms, β- and γ-actin, are crucial for slow, rapid, bulk, and overshoot endocytosis at large calyx-type synapses, and for slow endocytosis and bulk endocytosis at small hippocampal synapses. Polymerized actin provides mechanical force to form endocytic pits. Actin also facilitates replenishment of the readily releasable vesicle pool, likely via endocytic clearance of active zones. We conclude that polymerized actin provides mechanical force essential for all kinetically distinguishable forms of endocytosis at synapses. [ABSTRACT FROM AUTHOR]

Study Objective: To investigate the association between dexmedetomidine administration and outcomes in critically ill patients with sepsis-associated acute kidney injury (SA-AKI).Design: A single-center, retrospective, cohort study.Setting: Intensive care unit (ICU).Patients: A total of 2192 critically ill patients with SA-AKI were included in the analysis, which identified from the Medical Information Mart for Intensive Care (MIMIC-IV) database between 2008 and 2019.Interventions: Intravenous infusion of dexmedetomidine.Measurements: The primary outcome was recovery of renal function. In-hospital mortality, vasopressor requirements, length of ICU and hospital stay were considered secondary outcomes. The Cox proportional hazards, logistic regression, and linear regression models were used to assess the association between dexmedetomidine and outcomes. Propensity score matching (PSM) analysis was used to match patients receiving dexmedetomidine to those without treatment.Main Results: After PSM, 719 matched patient pairs were derived from patients who received dexmedetomidine and those who did not. The administration of dexmedetomidine was associated with a higher rate of renal recovery [61.8% vs. 55.8%, hazard ratio (HR) 1.35; P = 0.01], reduced in-hospital mortality [28.3% vs. 41.3%, HR 0.56; P < 0.001], and prolonged intensive care unit (ICU) stay [15.8d vs 12.6d, HR 2.34; P < 0.001] and hospital stay [23.7d vs 19.7d, HR 4.47; P < 0.001]. No significant difference was found in vasopressor requirements in patients with SA-AKI. Nevertheless, results illustrated that dose receiving between 0.30 and 1.00 μg/kg/h and duration using under 48 h of dexmedetomidine was associated with improvements in renal function recovery in SA-AKI patients.Conclusion: Dexmedetomidine administration was associated with improvements in renal function recovery and in-hospital survival in critically ill patients with SA-AKI. The results need to be verified in further randomized controlled trials. [ABSTRACT FROM AUTHOR]

In recent years, it has been widely accepted that transcription factor 7-like 2 (TCF7L2) is associated with type 2 diabetes mellitus (T2DM) in multiple ethnic groups, especially its single nucleotide polymorphisms of rs7903146C/T, rs12255372G/T and rs290487T/C. However, the results previously obtained in Chinese Han population are often inconsistent. For clearing this issue, herein we performed meta-analysis based on the reports that can be found to assess the association. In the meta-analysis, Odds ratio (OR) and 95% confidence interval (95% CI) were calculated with random-effect model or fixed-effect model based on the heterogeneity analysis. The quality of included studies was evaluated by using the Newcastle-Ottawa Scale. The sensitivity analysis was used to confirm the reliability and stability of the meta-analysis. In total, 20 case-control studies with 9122 cases of T2DM and 8017 controls were included. Among these case-control studies, we selected 13 ones on rs7903146 C/T, 5 ones on rs12255372 G/T, 8 ones on rs290487 T/C. The results indicated that rs7903146C/T polymorphism was significantly associated with T2DM (T vs. C, OR = 1.73, 95% CI = 1.39–2.16). There was no evidence that rs12255372G/T and rs290487T/C polymorphisms increased T2DM risk (T vs. G, OR = 1.77, 95% CI = 0.88–3.56; C vs. T, OR = 1.08, 95% CI = 0.93–1.25). Subgroup analysis of different regions proved the relationship between rs7903146C/T polymorphism and T2DM risk in both the northern and the southern China. The association of rs290487 with T2DM was affected by body mass index, whereas the association of rs7903146 and rs290487 with T2DM was influenced neither by age nor by sex. In conclusion, this study indicated that the rs7903146C/T polymorphism of the TCF7L2 gene had a significant effect on T2DM risk in Chinese Han population, with rs12255372G/T and rs290487T/C polymorphisms showing no significant effect. [ABSTRACT FROM AUTHOR]