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Variability of corticosteroid effects in cardiac arrest patients across age groups

Li YR, Kang YN, Chen KH

Am J Emerg Med, 2024 Jun 15.
PMID: 38960749 DOI: 10.1016/j.ajem.2024.06.014
Effects of mindfulness-based preoperative intervention for patients undergoing elective surgery: A meta-analysis

Tung KM, Su Y, Kang YN, Hou WH, Hoang KD, Chen KH, et al.

J Psychosom Res, 2024 Apr 13;181:111666.
PMID: 38657565 DOI: 10.1016/j.jpsychores.2024.111666

OBJECTIVE: Patients often experience pain and psychological distress when undergoing elective surgeries. Mindfulness-based interventions have been proposed as potential strategies to address these challenges. This meta-analysis aims to evaluate the efficacy of preoperative mindfulness-based interventions on several outcomes for patients undergoing elective surgery, including preoperative anxiety/depression, postoperative anxiety/depression, postoperative pain, and quality of life (QOL).
METHODS: This meta-analysis encompassed randomized controlled trials published in the database PubMed, Cochrane, and Embase to August 2023. Mindfulness-based interventions were compared to control groups, who received treatment as usual (TAU). The RevMan software was employed to assess each outcome by using standardized mean difference based on patient-reported data. Subgroup analyses were further performed according to different categories of surgical types.
RESULTS: Eight RCTs with a total of 685 patients were identified. This meta-analysis demonstrated significant difference in preoperative anxiety (SMD:-0.36, 95% CI: -0.62 to -0.11, p = .006) and postoperative pain immediately (SMD:-0.65,95% CI: -1.09 to -0.20, p = .004), 2-3 days (SMD:-0.40, 95% CI:-0.78 to -0.02, p = .04),at 14 days (SMD:-0.48,95% CI: -0.85 to -0.12, p = .009) and 28 days (SMD:-0.89,95% CI: -1.55 to -0.23, p = .008) postoperatively. However, there were no differences between postoperative anxiety, preoperative/postoperative depression, and QOL.
CONCLUSION: Our findings suggest preoperative mindfulness-based interventions can effectively manage preoperative anxiety and postoperative pain in patients scheduled for elective surgery. Further research is warranted to explore the different timing and types of mindfulness-based intervention.
Stem cell-derived conditioned medium for alopecia: A systematic review and meta-analysis

Chien WY, Huang HM, Kang YN, Chen KH, Chen C

J Plast Reconstr Aesthet Surg, 2024 Jan;88:182-192.
PMID: 37983981 DOI: 10.1016/j.bjps.2023.10.060

BACKGROUND: Alopecia is a common and distressing medical condition that has been related to psychiatric disorders. Stem cell-derived conditioned medium (CM), a novel therapy for hair regeneration, has shown effectiveness in several trials.
METHODS: This meta-analysis aims to explore the effectiveness of stem cell-derived CM in improving hair growth for patients of alopecia. We prospectively registered this systematic review and meta-analysis in PROSPERO (CRD42023410249). Clinical trials that the enrolled participants suffering from alopecia applied stem cell-derived CM were included. We calculated the mean and standard deviation for the hair density and thickness.
RESULTS: Ten clinical trials were included in our analysis. On the basis of eight clinical trials (n = 221), our pooled results indicate that stem cell-derived CM is effective in increasing hair density (mean difference [MD]: 14.93, confidence interval [95% CI]: 10.20-19.67, p
Fulltext Perioperative application of chatbots: a systematic review and meta-analysis

Lin SJ, Sun CY, Chen DN, Kang YN, Lai NM, Chen KH, et al.

BMJ Health Care Inform, 2024 Jul 20;31(1).
PMID: 39032946 DOI: 10.1136/bmjhci-2023-100985

BACKGROUND AND OBJECTIVES: Patient-clinician communication and shared decision-making face challenges in the perioperative period. Chatbots have emerged as valuable support tools in perioperative care. A simultaneous and complete comparison of overall benefits and harm of chatbot application is conducted.
MATERIALS: MEDLINE, EMBASE and the Cochrane Library were systematically searched for studies published before May 2023 on the benefits and harm of chatbots used in the perioperative period. The major outcomes assessed were patient satisfaction and knowledge acquisition. Untransformed proportion (PR) with a 95% CI was used for the analysis of continuous data. Risk of bias was assessed using the Cochrane Risk of Bias assessment tool version 2 and the Methodological Index for Non-Randomised Studies.
RESULTS: Eight trials comprising 1073 adults from four countries were included. Most interventions (n = 5, 62.5%) targeted perioperative care in orthopaedics. Most interventions use rule-based chatbots (n = 7, 87.5%). This meta-analysis found that the majority of the participants were satisfied with the use of chatbots (mean proportion=0.73; 95% CI: 0.62 to 0.85), and agreed that they gained knowledge in their perioperative period (mean proportion=0.80; 95% CI: 0.74 to 0.87).
CONCLUSION: This review demonstrates that perioperative chatbots are well received by the majority of patients with no reports of harm to-date. Chatbots may be considered as an aid in perioperative communication between patients and clinicians and shared decision-making. These findings may be used to guide the healthcare providers, policymakers and researchers for enhancing perioperative care.
Intradermal Injection of Tranexamic Acid for the Treatment of Adult Melasma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Chen LY, Kang YN, Hoang KD, Chen KH, Chen C

Facial Plast Surg Aesthet Med, 2024 Nov 22.
PMID: 39574359 DOI: 10.1089/fpsam.2024.0187

Background: Melasma is a chronic skin pigmentation disorder, and intradermal injection of tranexamic acid (TXA) is an effective treatment option for melasma with limited comparative efficacy studies. Objectives: To compare the effectiveness of TXA injections with other treatment modalities for patients with melasma, as measured by Melasma Area and Severity Index (MASI). Methods: A total of 17 eligible randomized controlled trials were included in the meta-analysis. The MASI and the modified MASI served as the primary outcome measures of treatment effectiveness. Patient satisfaction was also evaluated. Results: Among the various administration routes for TXA, intradermal injection and microneedling demonstrated superior effectiveness, followed by oral administration and topical application. As for patient satisfaction, oral administration outperformed the injection method, whereas topical administration significantly underperformed injection. Furthermore, TXA injections were more effective than the majority of non-TXA standard treatments for melasma. Conclusions: This meta-analysis and systematic review suggested that intradermal TXA injection is an effective alternative for melasma treatment, with potential advantages over other administration routes.
Fulltext Pathogenic Variants in CEP85L Cause Sporadic and Familial Posterior Predominant Lissencephaly

Tsai MH, Muir AM, Wang WJ, Kang YN, Yang KC, Chao NH, et al.

Neuron, 2020 Apr 22;106(2):237-245.e8.
PMID: 32097630 DOI: 10.1016/j.neuron.2020.01.027

Lissencephaly (LIS), denoting a "smooth brain," is characterized by the absence of normal cerebral convolutions with abnormalities of cortical thickness. Pathogenic variants in over 20 genes are associated with LIS. The majority of posterior predominant LIS is caused by pathogenic variants in LIS1 (also known as PAFAH1B1), although a significant fraction remains without a known genetic etiology. We now implicate CEP85L as an important cause of posterior predominant LIS, identifying 13 individuals with rare, heterozygous CEP85L variants, including 2 families with autosomal dominant inheritance. We show that CEP85L is a centrosome protein localizing to the pericentriolar material, and knockdown of Cep85l causes a neuronal migration defect in mice. LIS1 also localizes to the centrosome, suggesting that this organelle is key to the mechanism of posterior predominant LIS.