OBJECTIVE: To summarize the terms and definitions related to neurofibromatosis type 1 (NF1) with a view to standardizing and unifying the existing terminology system. METHODS: To review the research literature related to NF1 at home and abroad, and to summarize the expressions of the disease and related terms. RESULTS: There are still some limitations in the current knowledge of NF1, especially in the expression of the terminology, and there are discrepancies in the description and naming of NF1-related features in different medical literatures and clinical guides. There are differences in the description and naming of NF1-related features in different medical literature and clinical guidelines. Through a systematic review of the literature, this paper provides a detailed compendium and summary of the terms and definitions of NF1-related clinical manifestations, pathological features, and genetic types, and further standardizes and unifies existing diagnostic criteria and terminology systems. CONCLUSION: The terms and definitions of NF1-related clinical manifestations are summarized to enhance the knowledge of clinicians and researchers related to NF1.

BACKGROUND: Up to 80% of patients in the United States report dissatisfaction with pain management following orthopaedic surgery. Inadequate pain management is linked to negative outcomes, including increased costs, readmission rates, and chronic pain risk. Traditional pain management protocols often emphasise the biological components of pain, overlooking psychological and social. This systematic review addresses this gap by answering two key questions: (1) What factors are associated with increased risk of unsatisfactory pain management following orthopaedic surgery? (2) What are the key components of successful pain management protocols following orthopaedic surgery? METHODS: PRISMA guidelines were followed with a search of relevant online databases. Studies were included if they were in English, provided patient feedback/satisfaction with pain management (quantitative studies) or provided satisfaction with pain management or healthcare team feedback (qualitative studies) or explored patient variables associated with satisfaction with pain management. RESULTS: Of the 845 articles screened, 27 met the inclusion criteria. Synthesis suggested that while perceived severity and duration of pain are often assumed to be the primary drivers of patient satisfaction related to pain management, patients with a sense of control over their pain reported higher satisfaction, regardless of actual pain level. History of opioid misuse, patient expectations, and patient mental health were associated with dissatisfaction. CONCLUSION: Pre-operative education and ongoing communication, particularly regarding patient risk-factors and multi-modal pain management strategies, appear to enhance patients' sense of control and satisfaction. Future research should explore whether individualised pre-operative education can improve satisfaction with post-surgical orthopaedic pain management.

Evidence shows that inflammatory responses play an essential role in the development of brain metastases (BM). The goal of this meta-analysis was to critically evaluate the literature regarding the use of the neutrophil to lymphocyte ratio (NLR) to predict the prognosis of patients with BM to help clinicians institute early interventions and improve outcomes. We conducted systematic review and meta-analysis, utilizing data from prominent databases, including PubMed, Cochrane Library and China National Knowledge Infrastructure databases. Our inclusion criteria encompassed studies investigating the studies that assessed the association between NLR and overall survival (OS). We included 11 articles, with 2629 eligible patients, to evaluate the association between NLR and OS. High NLR was significantly associated with shorter OS, with a pooled hazard ratio (HR) of 1.82 (95% CI 1.57-2.11). Subgroup analysis revealed that this association was consistent across different regions, with HRs of 2.03 (95% CI 1.67-2.46) in Asian populations and 1.58 (95% CI 1.35-1.84) in non-Asian populations. Additionally, in a subgroup analysis based on NLR cut-off values, patients with NLR ≥ 3 had an HR of 1.69 (95% CI 1.46-1.96), while those with NLR < 3 had an HR of 2.26 (95% CI 1.64-3.11). Sensitivity analysis confirmed that no single study significantly influenced the pooled effect size. Our meta-analysis confirmed the prognostic value of NLR in patients with brain metastasis.

OBJECTIVES: To investigate the selection rules of acupoints for promoting gastrointestinal function recovery after colorectal cancer surgery using complex network technology. METHODS: Relevant literatures on acupuncture and moxibustion for promoting gastrointestinal function recovery after colorectal cancer surgery were searched from databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP Chinese Journal Service Platform, and SinoMed from retrieved to May 9, 2023. Literatures were selected based on inclusion and exclusion criteria, and a database of acupuncture and moxibustion for promoting gastrointestinal function recovery after intestinal cancer surgery was established. Association rule analysis was performed using IBM SPSS Modeler 18.0. Clustering analysis was performed using IBM SPSS Statistics 26.0. Complex network analysis was conducted using Gephi0.9.2. RESULTS: A total of 255 articles were included, covering 113 acupoints, with a total usage frequency of 1 080 times. The top 5 frequently used acupoints were Zusanli (ST36), Shangjuxu (ST37), Tianshu (ST25), Zhongwan (CV12), and Neiguan (PC6). The meridians predominantly used were the Stomach Meridian, Conception Vessel, and Spleen Meridian. Commonly used specific acupoints included lower he-sea points, five shu acupoints, crossing points, and mu-front acupoints. Association rule analysis showed that the acupoint combination with the highest support degree was ST36-ST37 (33.82%), followed by ST36-ST25 (23.53%), ST36-CV12 (23.53%), and ST36-PC6 (22.43%). Clustering analysis identified 3 effective clusters. Complex network analysis revealed two core groups of acupoints：the back-lower limb prone position group and the abdomen-limb supine position group. Intervention measures primarily involved filiform needle acupuncture and electroacupuncture. Uniform reinforcing-reducing method was mostly used techniques, with strongly associated acupoints being ST37 and ST36；lifting-thrusting and twisting reducing method came secondly, with strongly associated acupoints being ST25 and CV12. Overall, reducing technique was used more frequently than reinforcing technique. CONCLUSIONS: Acupuncture and moxibustion for promoting gastrointestinal function recovery after intestinal cancer surgery focuses on strengthening and harmonizing the spleen and stomach, cultivating the body's foundation, and regulating qi flow. The specific acupoints on the Stomach Meridian, Conception Vessel, and Spleen Meridian were mainly selected, and filiform needle acupuncture and uniform reinforcing-reducing technique were mainly used to realize the bidirectional regulation characteristics and advantages of acupuncture.

Background: Long COVID, which characterized by a constellation of persistent symptoms following the initial COVID-19 viral infection. Our primary questions were how the characteristics of people diagnosed with Long COVID differed from matched individuals who did not have a diagnosis of Long COVID after at least one confirmed positive COVID-19 test and how the diagnosis of Long COVID was influenced by COVID-19 vaccination. Methods: This was a retrospective observational cohort study using data collected from 1st January 2020 to 31st January 2024. The primary outcome was a primary care coded diagnosis, or referral for treatment, of Long COVID following an acute COVID-19 infection. Findings: We identified 26626 individuals with a diagnosis of Long COVID and at least one previous recorded COVID-19 positive test. These were matched by age and sex with 133165 individuals with at least one previous recorded COVID-19 positive test but no recorded diagnosis of Long COVID. There was a higher proportion of people with 2,3 4 and 5 or more comorbidities in the diagnosed Long COVID group. Black and Black British ethnicity (+28%) and Mixed ethnicity (+37%) vs White ethnicity were associated with a higher likelihood of a Long COVID diagnosis. Those in the most disadvantaged Townsend Index quintile were more than 2.3 times as likely to have Long COVID than the most advantaged quintile. Risk of Long COVID increased by 5.7% per comorbidity. Risk of Long COVID doubled for every additional positive COVID test.There also a higher proportion of people with more than one COVID-19 positive test and more than one COVID-19 vaccination in the diagnosed Long COVID group.Finally, we went on to look at mortality following a COVID-19 infection. It was apparent that a diagnosis of Long COVID was associated with a reduced mortality rate. Each COVID vaccine reduced chance of death by 42%. Female sex was associated with lower risk of death. More disadvantaged individuals by Townsend quintile were more likely to have died  - nearly 2x for most deprived compared to least deprived quintile.  Each additional comorbidity increases chance of death by 44%. Each positive COVID-19  test increased chance of death by 5%. Interpretation: Increasing social disadvantage was associated with a greater likelihood of being diagnosed with Long COVID as was being of Black/Mixed ethnicity. Risk of Long COVID increased by 5.7% per comorbidity. Risk of Long COVID doubled for every additional positive COVID test with vaccination number modulating this effect. Diagnosis of Long COVID was associated with a reduced mortality over a 4 year period. Funding: The time of co-author RW was supported by the NIHR Applied Research Collaboration Greater Manchester (NIHR200174) and the NIHR Manchester Biomedical Research Centre (NIHR203308). Declaration of Interest: No author has any conflict of interest. Ethical Approval: The legal basis for use of patient data in this study was defined in the national Control of Patient Information (COPI) notice (Notice under Regulation 3(4) of the Health Service Control of Patient Information Regulations of 2002) which gives NHS organisations a legal requirement to share data for the purposes of the COVID-19 response. The study was also reviewed and approved by the Greater Manchester Care Record (GMCR) Expert Research Group (ERG) reference number RQ066. The data used in the analyses presented were obtained with the permission of the Greater Manchester Care Record Board and were fully anonymised prior to being made available to the investigators.

The aim of this study was to assess the emotional state, habits and routines (measured through an ad-hoc questionnaire), personality traits (LOT-R, PFRS and COPE-28) and mental health (EBP and GHQ-12) of 71 Spanish high-performance skaters (38 men and 33 women) during COVID-19 confinement. The results indicate a good adaptation of the athletes at the cognitive, emotional and behavioural levels during the confinement. Skaters stand out for optimism, resilience and an active coping style, which may be positive regulators of the behavioural response. Distress is associated with lower resilience and greater avoidance coping. Women presented worse emotional response and greater difficulty to sleep than men. It was concluded that the athletes examined presented a positive profile that makes them cope adequately with confinement, in which potential gender differences need to be considered.

This study assesses the implementation of fiscal rules in Uganda from the time they were adopted from 2013/14 to 2021/22. The study uses annual time series data from the Ministry of Finance, Planning, and Economic Development. It also relies on the review of the relevant government and policy documents. The results suggest that, before the pandemic, the effectiveness of fiscal rules was hampered by the complexity of the debt rule, weak incentives for compliance at the regional and national level, overreliance on debt sustainability analyses results, and the lack of commitment to deficit rule in fiscal plans, regional surveillance and coordination system and an independent national institution among others. During the pandemic, fiscal rules' effectiveness was compromised by an uncoordinated fiscal response at a regional level, delays in developing a credible timeline and procedures to revert to the rule, and unrealistic targets for the fiscal rules, among others. The study suggests that to ensure the effectiveness of fiscal rules, the government should develop a clear and robust communication strategy, develop a clear deficit and debt reduction strategy, set realistic fiscal rules, establish or support the creation of an independent institution, strengthen the budget process to ensure compliance with the rules and taking a holistic view of public debt sustainability.

BACKGROUND: Obesity is associated with increased risk of surgical complications in some settings. OBJECTIVE: As a precursor to a systematic review, we conducted a scoping review of intentional preoperative weight loss to describe these interventions, their feasibility and effectiveness for patients with gastrointestinal cancer. METHODS: In April 2024, Ovid MEDLINE, EMBASE, CINAHL, and Google Scholar were searched for primary studies of intentional weight loss before elective gastrointestinal cancer surgery. Extracted data encompassed recruitment and attrition, intervention types, adherence, anthropometric and body composition changes, and surgical outcomes. Study quality was assessed using the Risk of Bias In Non-randomized Studies of Interventions tool. RESULTS: The search produced 7 articles (4 non-randomized clinical trials), which were all conducted in Japan, and involved 258 participants with a baseline BMI ≥25 kg/m2. Weight loss interventions included dietary modification (n = 3), exercise (n = 1), and combination (n = 3). None of the articles reported rates of recruitment, 2 adherence (97-100 %), and 4 reported attrition rates (0-18 %). All reported weight reductions of -1.3 to -6 kg and 4.5-6.9 % (n = 7), compared to baseline. Three of four non-randomized trials observed a reduction in postoperative complications, as compared to control; yet all trials were at critical risk of bias. CONCLUSION: Strong conclusions could not be made due to the limited reporting and critical risk of bias; further systematic review is not recommended at this time. To establish more robust evidence, there is a clear need for high-quality trials.

BACKGROUND: The purpose of this article is to discuss the relationship between the therapeutic bioactivity of basidial fungal polysaccharides (BFPs) BFPs and their structural characteristics and conformational features, as well as to characterize the mechanisms of action of BFPs in diseases of various origins. METHODS: The review was conducted using the PubMed (Medline), Scopus, Web of Science and the Russian Science Citation Index databases. 8645 records were identified, of which 5250 were studies (86 were randomized controlled trials). The period covered is from 1960 to the present. The most significant studies conducted mainly in Southeast Asian countries were selected for the review. RESULTS: Based on clinical studies, as well as the results obtained on in vivo, in vitro and ex vivo models, it has been proven that BFPs have diverse and highly effective biological activity in the human body in various diseases. The production of BFPs-based vaccines is an innovative strategy from a clinical and biochemical point of view, since as potential immunoprotective and low-toxic biopolymers they have innate immune receptors in the body. Promising results have been obtained in the development of antidiabetic drugs, probiotic, renoprotective and neurodegenerative dietary supplements. CONCLUSIONS: The biological activity, mechanism of action and specific therapeutic effect of BFPs largely depend on their structural and physicochemical characteristics. BFPs as multifunctional macromolecular complexes with low toxicity and high safety are ideal as new powerful pharmaceuticals for the treatment and prevention of many diseases.

BACKGROUND: Dyslipidemia is considered a substantial risk factor for coronary heart disease (CHD). Blood lipid levels in patients with CHD influence cardiovascular events. Therefore, it is critical to monitor and control these levels. As a traditional, complementary alternative therapy, acupuncture regulates blood lipid levels in patients with CHD. More acupuncture-related treatments are currently available. However, systematic reviews or evidence-based summaries have yet to be conducted. METHODS: This study included a randomized controlled trial of the effects of acupuncture-related therapies on blood lipid levels in CHD patients. The outcome indicators were changes in the TC, TG, LDL-C, and HDL-C levels. Two independent reviewers extracted data from PubMed, Web of Science, EMBASE, Cochrane Library, Medline (Ovid), China Knowledge Network, Wanfang, Vipshop, and SinoMed databases until January 7 2024. The literature quality was assessed using RevMan 5.4.1. The data were analyzed using the Frequentist network meta-analysis with STATA 15.1 software. Network meta-analysis was used to compare direct and indirect evidence, and a cumulative ranking curve (SUCRA) was used to evaluate the curative effect. For consistency, global inconsistency and ring-inconsistency test evaluations were used. The Cochrane bias risk assessment tool was used to assess quality. RESULTS: Fourteen studies with 1416 patients were included in the study. The evidence network shows that there are many studies on acupuncture and warm acupuncture. According to the direct comparison and SUCRA ranking, acupuncture reduced TC [-1.82 (-3.36, -0.28)], heat-sensitized moxibustion lowered TG [-2.12 (-3.55, -0.69)], LDL-C [-1.37 (-2.09, -0.66)], and increased HDL-C [0.87 (0.52, 1.22)]. These two interventions were the first in the SUCRA ranking. The inconsistency analysis revealed that direct evidence corresponded with indirect evidence. There were some methodological defects in the included studies, and some studies did not implement blinding methods, had small sample sizes or other problems. CONCLUSIONS: Heat-sensitized moxibustion significantly lowered TG and LDL-C levels and elevated HDL-C levels. Acupuncture significantly reduced TC levels. Heat-sensitized moxibustion is a more effective intervention than other acupuncture-related treatments for regulating blood lipid levels in patients with CHD. However, this study has several limitations, and clinical practice should be performed as needed.