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Background Dysphagia incidence after cardiac surgery is increasing due to increased complexity of the surgery and number of older patients, which has become one of the most severe complications of cardiac surgery, affecting patients' physical health and recovery. Objective To perform a review of available evidence on the incidence of dysphagia after cardiac surgery. Methods Databases of PubMed, Embase, Cochrane Library, CINAHL, Web of Science, CBM, CNKI, Wanfang Data, and VIP were searched from inception to May 2022 for published studies on the incidence of dysphagia after cardiac surgery. Two researchers independently conducted a literature enrollment, quality assessment, and data extraction. Meta-analysis was conducted using Stata 15.0. Results Fifteen studies with 7 880 patients were included. The meta-analysis revealed that the overall incidence of dysphagia after cardiac surgery was 13.3%〔95%CI (10.1%, 16.5%) 〕. Further region-specific analysis indicated that, the incidence of dysphagia following cardiac surgery in Asia, North America, and Oceania was 16.6%〔95%CI (10.4%, 22.8%) 〕, 10.0%〔95%CI (6.1%, 13.8%) 〕, and 17.4%〔95%CI (12.3%, 23.5%) 〕, respectively. According to sex-specific analysis, the incidence of dysphagia following cardiac surgery was 16.9%〔95%CI (11.8%, 21.9%) 〕, and 16.4%〔95%CI (11.1%, 21.8%) 〕 in male and female patients, respectively. The analysis based on age group indicated that the dysphagia incidence following cardiac surgery in patients aged 48 hours was 1.0%〔95%CI (0.3%, 1.8%) 〕, 6.4%〔95%CI (4.4%, 8.3%) 〕, 16.8%〔95%CI (9.5%, 24.1%) 〕, and 55.0%〔95%CI (28.0%, 82.0%) 〕, respectively. In addition, chronic kidney disease, chronic lung disease, previous history of cerebrovascular accident, atrial fibrillation, heart failure, intraoperative transesophageal echocardiography, perioperative stroke and sepsis were associated with a higher incidence of dysphagia after cardiac surgery. The results of the meta-analysis were robust, as shown by sensitivity analysis. Both Begg's and Egger's tests yielded P-value

Background Considering that our country has entered an aging society, the health problems of the older people has evolved into a concern due to the association with a variety of diseases. In recent years, Chinese households and society have suffered a serious economic burden due to the increasing prevalence of dysphagia among the elderly. Objective The purpose of this study is to evaluate the prevalence of dysphagia in the elderly in China systematically. Methods PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP, Wanfang Data, and China Biomedical Literature Database were searched for epidemiological studies related to the prevalence of dysphagia in the elderly in China. Searches were conducted from database inception to May 2022. Two researchers were responsible for screening literature and extracting data according to the inclusion and exclusion criteria. The AHRQ scale was used to evaluate the quality of cross-sectional studies. Meta-analysis was performed with Stata 15.0 software. Results A total of 22 articles were analyzed, containing 308 289 patients, including 47 940 patients with dysphagia. Meta-analysis revealed that the prevalence of dysphagia in the elderly in China was 66.0%〔95%CI (58.0%, 73.0%) 〕. According to subgroup analysis, among elderly Chinese males and females dysphagia was prevalent in 38.0%〔95%CI (31.0%, 45.0%) 〕 and 38.0%〔95%CI (29.0%, 46.0%) 〕 of cases, respectively. The prevalence of dysphagia was 21.0%〔95 %CI (13.0%, 29.0%) 〕 in 60-69 years old, 28.0%〔95%CI (18.0%, 37.0%) 〕 in those aged 70-79, and 41.0%〔95%CI (31.0%, 50.0%) 〕 in those aged more than 80. In primary, secondary, and technical secondary school, and college and up, dysphagia was observed in 28.0%〔95%CI (20.0%, 35.0%) 〕, 32.0%〔95%CI (17.0%, 53.0%) 〕, 30.0%〔95%CI (18.0%, 42.0%) 〕 of the elderly. The prevalence of elderly dysphagia was 68.0% in the hospital〔95%CI (52.0%, 85.0%) 〕, 56.0%〔95%CI (41.0%, 71.0%) 〕 in the nursing home and 76.0%〔95%CI (56.0%, 97.0%) 〕 in the community. According to the Kubota Drinking Test, 32.0%〔95%CI (21.0%, 43.0%) 〕 of the elderly suffer from dysphagia, 41.0%〔95%CI (16.0%, 66.0%) 〕 exprience it according to the EAT-10 scale, and 35.0%〔95%CI (14.0%, 56.0%) 〕 suffer from it according to the Water Swallowing Test scale. Conclusion The prevalence of dysphagia among the elderly in China is 66.0%〔95%CI (58.0%, 73.0%) 〕. The prevalence of dysphagia among those≥80 years old, those with secondary school and technical secondary school education, elderly care in community, and those with dysphagia diagnosed by the EAT-10 scale is high. In order to improve the quality of life and reduce the prevalence of dysphagia among the elderly, we must pay more attention to and understand elderly dysphagia early.

Background: Fatigue is one of the most common and burdensome symptoms for patients with multiple sclerosis (PwMS), considerably impacting their quality of life and employment. Numerous reports have described the prevalence of MS-related fatigue, but there is no global consensus on this matter. Objective: To examine the global prevalence of MS-related fatigue and identify sources of heterogeneity in the published literature. Methods: A systematic review and meta-analysis were conducted. A comprehensive search of the PubMed, EMBASE, Cochrane Library, Web of Science, PsycINFO, CINAHL, China National Knowledge Infrastructure (CNKI), and Wanfang database for potential literature from 2000 to January 31, 2024. A random effects model was used to calculate the prevalence of MS-related fatigue. Subgroup analyses and a meta-regression were used to explore the sources of heterogeneity. Results: Sixty-nine studies from 27 countries were included. The global prevalence of MS-related fatigue was 59.1%, and it has decreased every decade since 2000. Fatigue was prevalent among females, those with lower education levels, those who were older, those with greater disability, and those with longer MS durations. The meta-regression revealed that fatigue measurement instruments were the largest source of heterogeneity. Conclusion: The prevalence of MS-related fatigue is quite high. Healthcare professionals should screen for and manage fatigue for PwMS as early as possible and pay attention to populations with a high prevalence of fatigue. The high heterogeneity among the prevalence rates due to differences in the fatigue scales suggests the importance of reaching a consensus on the best screening tools for MS-related fatigue. [ABSTRACT FROM AUTHOR]

Background: The exact pathogenesis of melasma is not yet known, and its treatment remains challenging. Mesotherapy with tranexamic acid (TXA) and vitamin C was both reported to have certain effects on melasma. In spite of that several articles have compared the efficacy and safety of the two drugs on melasma, most of them were clinical study with small sample size. Aims: To evaluate the efficacy and safety of mesotherapy with TXA versus vitamin C in treating melasma through meta‐analysis and systemic review. Methods: The authors searched PubMed, Web of Science, Springer, and ScienceDirect for studies that compared mesotherapy with TXA versus vitamin C as a treatment for melasma. Primary outcomes were change in melasma area and severity index (MASI) before and after the treatment. Results: Finally, five studies with a total of 127 patients were included in the systematic review. There was no statistic difference in the change in MASI score between the TXA and vitamin C groups (mean difference, 0.16; 95% CI, −0.79 to 1.11). Conclusions: Mesotherapy with both TXA and vitamin C is safe and effective in the treatment of melasma. [ABSTRACT FROM AUTHOR]

BackgroundChina has stepped into an aging society, and its aging population is rapidly increasing. Recent years have seen a notable increased dyslipidemia prevalence in older adults, which has gained growing attentions as a major risk for cardiovascular and cerebrovascular diseases in this population. There is little consistency between studies on dyslipidemia prevalence in Chinese older adults due to differences of size and features of sample, design and setting.ObjectiveTo systematically evaluate the prevalence of dyslipidemia among Chinese older adults.MethodsCross-sectional studies relevant to the prevalence of dyslipidemia among Chinese elderly population were searched in databases including CNKI, CBM, CQVIP, WanFang, PubMed, Web of Science, Embase and the Cochrane Library from inception to May 2021. Two researchers performed literature screening and data extraction, separately. The Agency for Healthcare Research and Quality methodology checklist was used to assess the risk of bias. Stata 15.1 was adopted for meta-analysis.ResultsA total of 19 cross-sectional studies were included, involving 101 931 cases, and 45 785 of them had dyslipidemia. Meta-analysis results showed that the overall prevalence of dyslipidemia among the participants was 48.0%〔95%CI (41.0%, 54.0%) 〕. Specifically, the prevalence of elevated total cholesterol (TC) , triglyceride (TG) , and low-density lipoprotein cholesterol (LDL-C) as well as lowered low high-density lipoprotein cholesterol (HDL-C) was 19.7%〔95%CI (13.8%, 25.5%) 〕, 20.8%〔95%CI (16.2%, 25.4%) 〕, 15.3%〔95%CI (10.7%, 19.8%) 〕, and 20.2%〔95%CI (7.9%, 32.4%) 〕, respectively. Sex-specific analysis found that men had higher prevalence of elevated LDL-C than women (17.2% vs 9.0%) . Women had higher overall prevalence of dyslipidemia than men (48.8% vs 39.5%) . Moreover, women also had higher prevalence of elevated TC (24.0% vs 12.9%) , and TG (23.4% vs 19.0%) , as well as lowered HDL-C (20.4% vs 14.7%) . Age-specific analysis revealed that dyslipidemia prevalence in age groups of 60-69, 70-79, and ≥80 years old was 39.9%, 31.8%, and 31.4%, respectively, showing a trend of decrease with age. The prevalence of elevated TC in 60-69 year-olds (12.9%) was higher than that of 70-79 year-olds (12.1%) or 80 year-olds and above (9.5%) . The prevalence of elevated LDL-C in 60-69 year-olds (10.0%) was higher than that of 70-79 year-olds (9.4%) or 80 year-olds and above (6.5%) . The prevalence of elevated TG in 70-79 year-olds (19.3%) was higher than that of 60-69 year-olds (16.4%) or 80 year-olds and above (15.5%) . The prevalence of lowered HDL-C in 70-79 year-olds (10.5%) was higher than that of 60-69 year-olds (9.7%) or 80 year-olds and above (9.5%) . Those aged ≥80 years had lower prevalence of various forms of dyslipidemia than 60-69 year-olds and 70-79 year-olds. Region-specific analysis indicated that compared to those from western China, participants from eastern China had higher overall prevalence of dyslipidemia (49.3% vs 36.8%) . Moreover, they also showed higher prevalence of elevated TC (23.0% vs 11.4%) , elevated LDL-C (21.3% vs 7.8%) and lowered HDL-C (13.5% vs 7.8%) . However, they had slightly lower prevalence of elevated TG (19.7% vs 20.0%) .ConclusionThe overall prevalence of dyslipidemia was high in Chinese older adults. Sex-, age group- and region-specific differences were found in the overall prevalence of dyslipidemia, and prevalence of various forms of dyslipidemia. Due to limited number and non-ideal quality of the included studies, the above conclusions need to be verified by more high-quality studies.

The sequential breakup of the supercontinent Pangaea since the Middle Jurassic is one of the crucial factors that has driven the biogeographical patterns of terrestrial biotas. Despite decades of effort searching for concordant patterns between diversification and continental fragmentation among taxonomic groups, increasing evidence has revealed more complex and idiosyncratic scenarios resulting from a mixture of vicariance, dispersal and extinction. Aquatic insects with discreet ecological requirements, low vagility and disjunct distributions represent a valuable model for testing biogeographical hypotheses by reconstructing their distribution patterns and temporal divergences. Insects of the order Megaloptera have exclusively aquatic larvae, their adults have low vagility, and the group has a highly disjunct geographical distribution. Here we present a comprehensive phylogeny of Megaloptera based on a large‐scale mitochondrial genome sequencing of 99 species representing >90% of the world genera from all major biogeographical regions. Molecular dating suggests that the deep divergence within Megaloptera pre‐dates the breakup of Pangaea. Subsequently, the intergeneric divergences within Corydalinae (dobsonflies), Chauliodinae (fishflies) and Sialidae (alderflies) might have been driven by both vicariance and dispersal correlated with the shifting continent during the Cretaceous, but with strikingly different and incongruent biogeographical signals. The austral distribution of many corydalids appears to be a result of colonization from Eurasia through southward dispersal across Europe and Africa during the Cretaceous, whereas a nearly contemporaneous dispersal via northward rafting of Gondwanan landmasses may account for the colonization of extant Eurasian alderflies from the south. [ABSTRACT FROM AUTHOR]

Chauliodinae (fishflies), with their low capacity of long‐distance dispersal represent a suitable model insect group to investigate the biogeographical history. The genus Parachauliodes van der Weele, including the herein synonymized genus Sinochauliodes Liu & Yang, is endemic to East Asia. Here, we reconstruct the interspecific phylogeny of Parachauliodes based on mitochondrial DNA sequence data. Sinochauliodessyn.n. was recovered with a group of Parachauliodes species and not the sister group; we therefore treat it as the junior synonym of Parachauliodes. Species delimitation was performed combining the molecular identification with morphological evidence, with Parachauliodes inopinatussyn.n. treated as the junior synonym of Parachauliodes asahinai. The spatio‐temporal divergence pattern of Parachauliodes indicates that the genus might have originated from Eurasian continent no later than the early Miocene and the initial divergence within genus was likely to be correlated to the split of southwestern Japanese Islands from the continent. There likely was a southward dispersal in the Parachauliodes japonicus clade from southwestern Japan via the Ryukyus to Taiwan by the end of the Miocene. The present species diversity of the insular lineage of Parachauliodes was possibly shaped by island isolations and sympatric distribution. [ABSTRACT FROM AUTHOR]

We present a time‐calibrated phylogeny of the charismatic green lacewings (Neuroptera: Chrysopidae). Previous phylogenetic studies on the family using DNA sequences have suffered from sparse taxon sampling and/or limited amounts of data. Here we combine all available previously published DNA sequence data and add to it new DNA sequences generated for this study. We analysed these data in a supermatrix using Bayesian and maximum likelihood methods and provide a phylogenetic hypothesis for the family that recovers strong support for the monophyly of all subfamilies and resolves relationships among a large proportion of chrysopine genera. Chrysopinae tribes Leucochrysini and Belonopterygini were recovered as monophyletic sister clades, while the species‐rich tribe Chrysopini was rendered paraphyletic by Ankylopterygini. Relationships among the subfamilies were resolved, although with relatively low statistical support, and the topology varied based on the method of analysis. Greatest support was found for Apochrysinae as sister to Nothochrysinae and Chrysopinae, which is in contrast to traditional concepts that place Nothochrysinae as sister to the rest of the family. Divergence estimates suggest that the stem groups to the various subfamilies diverged during the Triassic‐Jurassic, and that stem groups of the chrysopine tribes diverged during the Cretaceous. [ABSTRACT FROM AUTHOR]

Objective: To investigate the influence of a hierarchical nursing model on rescue outcomes and nursing quality of patients with acute cerebral infarction (ACI)., Methods: A total of 120 patients with ACI admitted to our hospital from January 2020 and December 2020 were selected as the study subjects and were divided into a study group and a control group, with 60 patients in each group. The study group was treated with a hierarchical nursing model, while the control group was treated with a conventional nursing model. The rescue effects, living abilities, neurological function deficits before and after nursing, nursing quality, families' and physicians' satisfaction with rescue and nursing, and incidence rates of adverse reactions were compared between the two groups., Results: The time from intravenous injection to thrombolysis ( i.e. , door-to-needle time, DNT), time from pre-examination to triage for thrombectomy, and retention time in the emergency room of the study group were lower than those of the control group, while the success rate of rescue in the study group was higher than that in the control group ( P < 0.05). After nursing intervention, the scores of the National Institutes of Health Stroke Scale (NIHSS) and incidence rate of adverse reactions in the study group were lower than those in the control group, while the scores of Barthel scale and nursing quality and families' and physicians' satisfaction with nursing in the study group were higher than those in the control group ( P < 0.05)., Conclusion: Hierarchical nursing can remarkably shorten the rescue time, improve the success rate of rescue, neurological function and quality of life of patients with ACI, improve nursing quality of nursing staff, and reduce the incidence rate of adverse reactions., Competing Interests: None., (AJTR Copyright © 2021.)