title stringlengths 1 1.19k | keywords stringlengths 0 668 | concept stringlengths 0 909 | paragraph stringlengths 0 61.8k | PMID stringlengths 10 11 |
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Authors’ contributions | LZH was involved in the conception and design of the article, LZJ was involved in the supervision and critical review and editing of the manuscript, and ZAJ, XZ, and QGP were involved in discussions about the content of the manuscript. The author(s) read and approved the final manuscript. | PMC9979534 | ||
Funding | No.41310164 | This work was supported in part by the National Natural Science Foundation of China (No.41310164). | PMC9979534 | |
Availability of data and materials | All data generated or analyzed during this study are included in this published article. | PMC9979534 | ||
Declarations | PMC9979534 | |||
Ethics approval and consent to participate | Not applicable. | PMC9979534 | ||
Consent for publication | Not applicable. | PMC9979534 | ||
Competing interests | The authors declare no competing interests. | PMC9979534 | ||
References | PMC9979534 | |||
Purpose | knee arthroplasty, TKA | Personality traits, such as dispositional optimism and pessimism, have impact on a variety of health-related problems. Influence on outcome in total knee arthroplasty (TKA) could only be shown for other personality trait concepts, but not for dispositional optimism/pessimism. This study aims to examine the association ... | PMC10435416 | |
Methods | Knee-osteoarthritis | REGRESSION | Data were acquired in a multicentre, cross-sectoral, prospective study (the PROMISE Trial). Patients were followed for 12 months post-operatively. Dispositional optimism/pessimism was measured pre-operatively via the revised Life Orientation Test (LOT-R), pre- and post-operative function was measured via the 12 Item Kn... | PMC10435416 |
Results | 740 patients were analyzed. Optimistic LOT-R was significantly positively associated to the mean scores of KOOS-12 pre- and post-operative, while pessimistic LOT-R was significantly associated negatively (pre-operative: optimistic | PMC10435416 | ||
Conclusion | Optimism was positively associated with pre-operative joint function and, more importantly, post-operative functional outcome in TKA, while pessimism was associated with the opposite. Assessing patients’ general personality traits prior to surgery to identify pessimistic patients, hence being at risk for poor outcome i... | PMC10435416 | ||
Level of evidence | Prognostic Level III. | PMC10435416 | ||
Keywords | Open Access funding enabled and organized by Projekt DEAL. | PMC10435416 | ||
Introduction | osteoarthritis, end stage, OA, pain | OSTEOARTHRITIS | While total knee replacement is an overall successful procedure for pain relief and improvement of mobility in patients suffering from end stage osteoarthritis (OA), literature still reports up to 30% of patients not being satisfied with their post-operative outcome [Other research has shown that certain personality co... | PMC10435416 |
Materials and methods | All study data were derived from a multicenter, cross-sectoral, prospective healthcare research study (the PROMISE Trial) which was implemented in three different German hospitals, representing all levels of care. Sample size was chosen as available. Detailed methods descriptions (e.g., surgical techniques, rehabilitat... | PMC10435416 | ||
Criteria for inclusion and exclusion | After Institutional Review Board approval, all patients older than 18 years that met standardized criteria for surgery [ | PMC10435416 | ||
Data collection | ’ personality dimensions | Patients were followed for 12 months post-operatively during the regular administrative procedures of the participating hospitals. Evaluation started in 05/2018 and ended in 01/2021. Baseline data (age, age at surgery, sex, type of surgery, ASA score, BMI, marital status, education level and income) for the eligible pa... | PMC10435416 | |
Institutional Review Board approval | Approval from all ethics committees in the participating states in Germany was obtained prior to the study [Institutional Review Board approval: Submission No.: 837.533.17 (11367), Ethics Committee at the State Chambers of Physicians of Rhineland-Palatinate; B-F-2018-042, Ethics Committee at the State Chambers of Physi... | PMC10435416 | ||
Statistical analysis | REGRESSION | To quantify the possible impact of LOT-R optimism/pessimism on post-operative outcomes, several linear regression models were fitted, in which the respective outcomes (KOOS-12 post-operative) were regressed on the study variable LOT-R optimism/pessimism. In addition to the respective study variable, each regression mod... | PMC10435416 | |
Results | PMC10435416 | |||
Personality traits | Mean LOT-R optimism was 10.5 (SD 2.12). Mean LOT-R pessimism was 9.4 (SD 2.03). Distributions of LOT-R optimism and LOT-R pessimism are shown in Figs. Total distribution of LOT-R optimism in the cohort. Point value > 10 indicates “very optimistic”, 7–9 indicates “somewhat optimistic”, and < 7 “not optimistic”Total dist... | PMC10435416 | ||
Mean functional scores | Mean KOOS Scores for pre- and post-operative follow-ups in association with the respective optimistic and pessimistic categories are shown in Tables Mean KOOS-12 scores in LOT-R optimistic valuesMean KOOS-12 scores in LOT-R pessimistic values | PMC10435416 | ||
Pre-operative function and association with dispositional optimism/pessimism | REGRESSION | Optimistic patients showed significantly higher pre-operative KOOS-12 scores compared to their not optimistic counterparts (Association between the LOT-R-optimism values and the pre-operative KOOS-12 values in the cohort. Hexagons indicate patient clusters with lighter colors indicating a higher number of patients. The... | PMC10435416 | |
Post-operative function and association with dispositional optimism/pessimism | Associations of LOT-R optimism and LOT-R pessimism scores with absolute post-operative KOOS-12 scores (3, 6 and 12 months) in the multivariate analysis are shown in Table Association of optimism and pessimism with 3, 6 and 12 months post-operative absolute KOOS-12 scores, when adjusting for the confounders (i.e., KOOS-... | PMC10435416 | ||
Discussion | hip arthroplasty, TKA | DISORDERS | The most important findings of this study were the significant positive/negative association of dispositional optimism/pessimism with post-operative functional outcome after TKA measured via the KOOS-12 score. Optimistic patients showed significant higher KOOS-12 scores pre-operative as well as 3, 6 and 12 months post-... | PMC10435416 |
Limitations | depression, TKA, anxiety | This study has some limitations. First, other psychological variables known to interfere with post-operative outcome, such as depression and anxiety [However, due to the multi-center design, a large study sample size matching the general population of TKA patients in Germany [ | PMC10435416 | |
Conclusions | Dispositional optimism is positively associated with pre-operative joint function and, more importantly, post-operative functional outcome in TKA, whereas the opposite applies for pessimism. Assessing patients’ general personality traits prior to surgery to identify pessimistic patients, hence being at risk for poor ou... | PMC10435416 | ||
Author contributions | PD | FW participated in the design of the study, performed surgery, carried out data collection and abstraction, and drafted the manuscript. LE participated in the design of the study, performed surgery, carried out data abstraction and helped to draft the manuscript. RK performed statistical analysis. PD and TK conceived t... | PMC10435416 | |
Funding | Open Access funding enabled and organized by Projekt DEAL. This work was supported by the grant from the German Federal Joint Committee (01NVF16015). | PMC10435416 | ||
Data availability | The data that support the findings of this study are available on request from the corresponding author, FW. The data are not publicly available due to the German privacy laws in the medical sector. | PMC10435416 | ||
Declarations | PMC10435416 | |||
Conflict of interest | The authors declare that they have no competing interest. | PMC10435416 | ||
Ethical approval | Submission No.: 837.533.17 (11367), Ethics Committee at the State Chambers of Physicians of Rhineland-Palatinate. Submission No.: B-F-2018–042, Ethics Committee at the State Chambers of Physicians of Baden-Wuerttemberg. Submission No.: MC 84/2018, Ethics Committee at the State Chambers of Physicians of Hesse. | PMC10435416 | ||
Informed consent | Informed consent was obtained from all individual participants included in the study. | PMC10435416 | ||
References | PMC10435416 | |||
Background | depression | The study was designed to investigate effects of single intravenous injection of esketamine on the incidence of postpartum depression (PPD) after labor analgesia and explore the potential mechanisms. | PMC10668401 | |
Methods | inflammation | INFLAMMATION | A total of 120 women who underwent labor analgesia by epidural analgesia pump were enrolled and divided into two groups randomly. Esketamine at a dose of 0.2 mg/kg was intravenously injected after fetal disengagement in the test group and placebo was administered in the control group. The occurrence of PPD and side eff... | PMC10668401 |
Results | The incidence of PPD was significantly decreased both for one week and six weeks after delivery by using of esketamine (3.4% vs. 15.3%, p = 0.004 and 5.2% vs. 18.6%, p = 0.006, respectively). There were also significant differences between the stress and inflammation-related indicators in different time points in this ... | PMC10668401 | ||
Conclusions | depression | INFLAMMATION | Single intravenous injection of esketamine after delivery in participants underwent labor analgesia can decrease the occurrence of postpartum depression for one week and six weeks after delivery, while the side effects were not increased. The antidepressant effects of esketamine may be related to the reduction of stres... | PMC10668401 |
Trial registration | The trial was registered at the Chinese Clinical Trial Registry on 5/30/2022 (CTRI registration number—ChiCTR2200060387). URL of registry: | PMC10668401 | ||
Supplementary Information | The online version contains supplementary material available at 10.1186/s40360-023-00705-7. | PMC10668401 | ||
Keywords | PMC10668401 | |||
Introduction | Due to the particularity of physiology, maternal perinatal safety has been a special concern. At present, the labor analgesia is gradually recommended on the premise of ensuring maternal and fetal safety [Nowadays, medication combined with psychological counseling are mainly used for the treatment of PPD. However, long... | PMC10668401 | ||
Methods | PMC10668401 | |||
Study design | This randomized, double-blinded, controlled trial was conducted at the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China, from 6/1/2022 to 2/28/2023, which performed in accordance with the declaration of Helsinki. The Consolidated Standards of Reporting Trials (CONSORT) recommendations were fo... | PMC10668401 | ||
Study participants | Anxiety, organic or pharmacogenic depression, mental disorder, Self-rating Depression | COAGULATION DISORDERS | One hundred and twenty primiparous women who underwent labor analgesia, aged 22 to 38, with American society of Aneshesiologists (ASA) physical status II, with 1 fetal 0 labor, pregnancy time greater than 38 weeks and less than 42 weeks, and single term pregnancy, were enrolled. The exclusion criteria were as follows: ... | PMC10668401 |
Sample size estimation | Based on the results of our pre-experiment (10 participants in each group), the incidence of PPD at 6 weeks after delivery can be reduced by 12% in the tested group. Power analysis showed that a reduction rate of 15% with
CONSORT flow diagram. In the study, a total of 120 participants were enrolled initially and three... | PMC10668401 | ||
Randomization and allocation concealment | Participants were randomly assigned to one of two groups. Random tables were generated by SPSS 20.0. One hundred and twenty sealed envelopes were prepared by a statistician who did not participate in the study. The study was performed with neither patients’ nor observers’ awareness of the group to which each patient be... | PMC10668401 | ||
Study interventions | After entering the delivery room, peripheral venous access was opened in all participants, maternal heart rate, noninvasive blood pressure measurement, electrocardiography and pulse oximetry were monitored. All women were received oxygen for 3 L/min by transnasal catheter. Epidural anaesthesia were operated between L | PMC10668401 | ||
Outcome measurements | depression, nausea, peripheral venous blood before labor, vomiting | SIDE EFFECTS, POSTPARTUM HEMORRHAGE | The primary outcomes of the study were the incidence of PPD at one week and six weeks after delivery. The diagnosis of postpartum depression was based on the reference [Ramsay sedation score before analgesia (TAll women were tested levels of norepinephrine (NE), epinephrine (E) ,C-reactive protein (CRP), interleukin-6 ... | PMC10668401 |
Statistical analysis | The statistical analysis were performed using SPSS software package (version 25.0; IBM, Inc., Chicago, IL, USA). The continuous data were presented as mean (M) ± standard deviation (SD) and examined by independent t-test. The categorical data were shown as n(%) and examined with a Chi-square test. It was considered sta... | PMC10668401 | ||
Results | PMC10668401 | |||
Patient recruitment | failure of epidural puncture | In the study, a total of 120 participants were enrolled initially and three participants were excluded during the trial. One case was excluded for failure of epidural puncture, and another one was for changed to cesarean section in Group E, while one participant was excluded for failure of epidural puncture in Group C.... | PMC10668401 | |
Discussion | TRD, Pain, inflammation, ’ mood, pain, infection, hallucination, depression | INFLAMMATION, INFECTION | Pain in the perinatal period is one of the factors leading to the development of PPD. The symptoms of PPD are more prominent in women who experience frequent pain during childbirth [The traditional treatment for depression is to increase the amount of serotonin in the synaptic space to achieve the effect of alleviating... | PMC10668401 |
Conclusions | depression | INFLAMMATION | In conclusion, single intravenous injection of esketamine (0.2 mg/kg) after delivery in participants underwent labor analgesia can decrease the occurrence of postpartum depression for one week and six weeks after delivery, while the side effects were not increased. The antidepressant effects of esketamine may be relate... | PMC10668401 |
Authors’ contributions | BL, YZ, HX, HC and WW designed the study. QWsupervised the practical carrying out of the clinical trial. WY participated in the study’s conceptualization and sampling. ZY and HX analyzed the data. BL, YZ and WW wrote the manuscript. All authors read and approved the final manuscript. | PMC10668401 | ||
Funding | No funding was received for conducting this study. | PMC10668401 | ||
Data Availability | The datasets used and analyzed during the current study are available from the corresponding author on reasonable request. Wei Wang, e-mail: wangwei2024@163.com. | PMC10668401 | ||
Declarations | PMC10668401 | |||
Ethics approval and consent to participate | The study was performed in accordance with the declaration of Helsinki. Ethical approval for this study (2021-03-031-K01) was provided by the Institutional Ethics Committee of the Affiliated Jiangning Hospital of Nanjing Medical University. The registration of this study was approved in the Chinese Clinical Trial Regis... | PMC10668401 | ||
Consent for publication | Not Applicable. | PMC10668401 | ||
Competing interests | The authors declare no conflict of interests. | PMC10668401 | ||
Abbreviations | Depression | postpartum depressionAmerican society of Anesthesiologistsconsolidated standards of reporting trialsthe Self-rating Anxiety Scalethe Self-rating Depression ScaleEdinburgh Postpartum Depression ScalenorepinephrineepinephrineC-reactive proteininterleukin-6interleukin-10N-methyl-D-aspartate | PMC10668401 | |
References | PMC10668401 | |||
Background | breathlessness, COPD, Chronic breathlessness | CHRONIC OBSTRUCTIVE PULMONARY DISEASE, COPD | Chronic breathlessness in chronic obstructive pulmonary disease (COPD) is effectively treated with pulmonary rehabilitation. However, baseline patient characteristics predicting improvements in breathlessness are unknown. This knowledge may provide better understanding of the mechanisms engaged in treating breathlessne... | PMC10447378 |
Methods | COPD | COPD | Data from 71 participants with mild-to-moderate COPD recruited to a randomised double-blind controlled experimental medicine study of D-cycloserine given during pulmonary rehabilitation were analysed (ID: NCT01985750). Baseline variables, including brain-activity, self-report questionnaires responses, clinical measures... | PMC10447378 |
Results | breathlessness | Only models that included brain imaging markers of breathlessness-expectation successfully predicted improvements in Dyspnoea-12 score (sensitivity 0.88, specificity 0.77). D-cycloserine was independently associated with breathlessness improvement. Models that included only questionnaires and clinical measures did not ... | PMC10447378 | |
Conclusions | chronic breathlessness, breathlessness | BRAIN | Brain activity to breathlessness related cues is a strong predictor of clinical improvement in breathlessness over pulmonary rehabilitation. This implies that expectation is key in breathlessness perception. Manipulation of the brain’s expectation pathways (either pharmacological or non-pharmacological) therefore merit... | PMC10447378 |
WHAT IS ALREADY KNOWN ON THIS TOPIC | chronic breathlessness, breathlessness, COPD | CHRONIC OBSTRUCTIVE PULMONARY DISEASE, COPD | Pulmonary rehabilitation is an effective treatment for many, but not all people with chronic obstructive pulmonary disease (COPD who suffer from chronic breathlessness in COPD. Baseline patient characteristics predicting improvements in breathlessness are unknown. | PMC10447378 |
WHAT THIS STUDY ADDS | breathlessness, prerehabilitation breathlessness | This is the first study to identify a model capable of predicting changes in breathlessness over pulmonary rehabilitation at the individual patient level. The study shows that prerehabilitation breathlessness expectation related brain activity is a strong predictor of clinical improvement in breathlessness over pulmona... | PMC10447378 | |
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY | chronic breathlessness | Manipulation of the brain’s expectation pathways (either pharmacological or non-pharmacological) merits further testing in the treatment of chronic breathlessness. | PMC10447378 | |
Introduction | chronic breathlessness, cognitive behavioural, breathlessness, depression, COPD | CHRONIC OBSTRUCTIVE PULMONARY DISEASE, COPD | Chronic breathlessness is a key feature of chronic obstructive pulmonary disease (COPD) with symptoms often persisting despite maximal medical therapy. Pulmonary rehabilitation is the best treatment for chronic breathlessness in COPDBreathlessness severity is often poorly explained by objective clinical measures.Betwee... | PMC10447378 |
Methods and materials | A brief overview of materials and methods is presented here with full details included within
| PMC10447378 | ||
Participants | Seventy-one participants (18 female, median age 71 years (46–85 years)) ( | PMC10447378 | ||
Study protocol | Data for this analysis were acquired at baseline assessment held at the start of a pulmonary rehabilitation course, and following completion of the pulmonary rehabilitation at 6–8 weeks. At each study visit, identical measures were collected. Following the first visit, participants were randomised in a double-blind pro... | PMC10447378 | ||
Self-report questionnaires | Depression, breathlessness, Anxiety, Fatigue | All questionnaires (List of measures included within each of the three models (indicated by ‘X’)Drug ID labels corresponded to whether the participant received D-cycloserine or placebo.BCS, breathlessness catastrophising scale; BMI, body mass index; BORG, rating of perceived exertion; CES-D, Centre for Epidemiologic St... | PMC10447378 | |
Physiological measures | Spirometry and two Modified Shuttle Walk Tests (MSWT) were collected using standard protocols. | PMC10447378 | ||
MRI measures | PMC10447378 | |||
Image acquisition | MRI of the brain was carried out using a Siemens 3T MAGNETOM Trio. A T1-weighted (MPRAGE) structural scan (voxel size: 1×1 × 1 mm) was collected and used for registration purposes. A T2*-weighted, gradient echo planar image (EPI) scan sequence (TR, 3000 ms; TE 30 ms; voxel size: 3×3×3 mm) was used to collect functional... | PMC10447378 | ||
Word cue task | fearful breathlessness, breathlessness | Given sufficient fearful breathlessness exposures, the suggestion alone of the situation can be sufficient to drive a top-down neural cascade and produce breathlessness in the absence of afferent inputs. We drew on this link to probe the neural responses of breathlessness-related expectation by examining the activity o... | PMC10447378 | |
Analysis | PMC10447378 | |||
Regions of interest | Fifteen regions of interest were selected a priori (Region of interest map showing 15 brain areas. | PMC10447378 | ||
Brain imaging analysis | BRAIN | Image processing was carried out using the Oxford Centre for Functional MRI of Brain Software Library (FMRIB, Oxford, UK; FSL V.5.0.8; | PMC10447378 | |
Preprocessing and single subject models | Data were preprocessed according to standard protocols which included motion correction and physiological noise removal, before being entered into single subject general linear models. These models captured brain activity during the periods in which the breathlessness-related word cues were presented allowing us to exa... | PMC10447378 | ||
Definition of response to pulmonary rehabilitation | breathlessness | REGRESSION | Responsiveness to pulmonary rehabilitation was defined as a change in D12 score, a well-validated clinical measure of breathlessness, of three or more points, consistent with the minimal clinically important difference.Logistic regression coefficients for predictive power of the computationally derived brain-behaviour ... | PMC10447378 |
Predictive models | PMC10447378 | |||
Physiological measures | confusion | Spirometry and two MSWT were collected using standard protocols.Models were programmed using R V.3.6.1 (2019-07-05). Modelling procedure remained the same for each of the three models (A schematic of the modelling procedure adapted from an illustration by Chekroud and colleagues.All measures were centred and scaled. Ch... | PMC10447378 | |
Results | PMC10447378 | |||
Participants | breathlessness | At baseline the median MRC breathlessness score of the 71 participants was 3 (IQR 1), median FEV1/FVC (forced expiratory volume/ forced vital capacity) was 0.55 (IQR 0.15), median FEV1% predicted was 58 (IQR 21). | PMC10447378 | |
Responders and non-responders | A total of 41/71 participants in the primary dataset met the criteria of a change in D12 score of three or more points to be considered a responderAverage scores on questionnaire and behavioural measures before and after pulmonary rehabilitationVariance is expressed as IQR.Significance is reported as exploratory uncorr... | PMC10447378 | ||
Feature selection: brain imaging only model | The elastic net procedure identified 13 of 15 brain-derived metrics and drug as relevant for model inclusion ( | PMC10447378 | ||
Feature selection: brain and non-imaging measure model | The elastic net procedure identified 12 of 15 brain-derived metrics, 13 of 20 non-imaging measures including drug as relevant for model inclusion ( | PMC10447378 | ||
Feature selection: non-imaging measures model | Of the 20 questionnaire and physiological features available, only D12 survived the feature selection process ( | PMC10447378 | ||
Model results: internal validation | CORTEX | Three models with variables selected by the elastic net procedure were assessed for their ability to discriminate responders from non-responders (Model statistics for brain imaging only, brain and non-imaging measure models and non-imaging measures only modelAll models contained drug ID as an additional term.P value is... | PMC10447378 | |
Discussion | PMC10447378 | |||
Key findings | breathlessness, post-traumatic stress disorder, anxiety, pain | Using supervised machine learning, this study successfully identified markers that predict clinically relevant improvements in breathlessness over a course of pulmonary rehabilitation. The best model combined brain-imaging markers of breathlessness-expectation, self-report questionnaires and physiology measures, and de... | PMC10447378 | |
Limitations and future work | breathlessness | EVENTS | The major limitation of this study is the lack validation of the model in an external dataset. While some studies hold out a proportion of the original data to create an external validation dataset, this technique was not possible here due to restrictions of sample size. To address these limitations, we used a cross va... | PMC10447378 |
Data availability statement | Data are available on reasonable request. | PMC10447378 | ||
Ethics statements | PMC10447378 |
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