Journal of Multidisciplinary Healthcare最新文献

Objective: To analyze the current status, research hotspots, and trends in the application of artificial intelligence (AI) in cardiovascular disease (CVD) using bibliometric methods, providing a reference for future research.

Methods: A systematic search was conducted in the WoSCC for relevant literature published from database inception to March 5, 2025. VOSviewer v.1.6.20 was used for co-occurrence analysis of institutions (≥10 publications) and authors (≥5 publications), and Scimago Graphica V1.0.25 was used to visualize collaboration networks among countries/regions. CiteSpace 6.3.R1 was employed for institutional co-occurrence analysis (≥5 publications), keyword co-occurrence, and clustering analysis.

Results: A total of 1738 relevant articles were included, with a gradual increase in annual publications, especially after 2018. The United States led in both publication volume and total citations. Harvard Medical School was the most prolific institution. Saba, Luca, and Suri, Jasjit S. were the most productive authors. 《IEEE ACCESS》was the journal with the most publications. High-frequency keywords included machine learning, coronary heart disease, and CVD, forming 10 clusters. Main research areas included AI in disease diagnosis, classification, biomarker discovery, and AI system design. Co-cited literature clusters into four AI-CVD directions: classification, risk prediction, algorithm refinement, imaging. In addition, issues such as the interpretability and clinical acceptance of AI data quality and patient privacy protection models cannot be ignored.

Conclusion: Research on AI in the field of CVD is still in a stage of rapid development. Currently, the hotspots in this field focus on the application of AI in CVD diagnosis and classification, the application of AI in CVD risk prediction, and the precise utilization of AI in CVD imaging. How to develop explainable AI models is a hot topic of research in the coming period.

Objective: Heart rate recovery (HRR) is a validated prognostic marker in cardiovascular disease (CVD). This study evaluated and compared the effects of 4-week high-intensity interval training (HIIT) and moderate-intensity interval training (MIIT) on post-exercise HRR in patients with CVD.

Methods: A total of 1,020 CVD patients undergoing cardiac rehabilitation (Jan 2021-May 2024) were screened, and 209 who completed 12 sessions and cardiopulmonary exercise tests were included (HIIT: 82; MIIT: 127). The mean ages were 55.2 (HIIT) and 52.9 years (MIIT), with females comprising 34.1% and 34.6%, respectively. The MIIT protocol included four 8-min cycling bouts (RPE 12-14) with 2-min active recovery, while HIIT involved 20-25 × 30-s high-intensity bouts (RPE 14-15) alternating with 30-s low-intensity recovery.

Results: Both interventions significantly improved HRR (HIIT: 3.1±8.7 bpm, P = 0.002; MIIT: 3.0±10.0 bpm, P = 0.001), with no between-group difference (P = 0.816). Peak VO₂ similarly increased in both groups (HIIT: 3.3±2.8; MIIT: 3.0±3.6 mL·kg^-1·min^-1; P < 0.001). Other related measures were also notably improved (P < 0.05). Multivariable regression analysis revealed that the change in HRR was inversely associated with the change in resting heart rate in both HIIT (β = -0.227, P = 0.04) and MIIT (β = -0.318, P < 0.001) cohorts.

Conclusion: Both short-term HIIT and MIIT comparably enhance HRR in patients with CVD, highlighting the clinical applicability of interval training as an efficient option for patients with limited time availability. However, the retrospective design limits causal inference and requires confirmation in future studies.

Background: Stroke is a leading cause of long-term disability, with attentional deficits affecting most survivors and limiting independence, activities of daily living (ADL), and quality of life. Conventional rehabilitation often lacks engagement and accessibility, which underscores the need for innovative strategies. Digital health interventions incorporating gamification may enhance attentional rehabilitation. However, the evidence remains limited.

Objective: This review systematically evaluated the effectiveness, safety, and gamification strategies of digital health interventions for attentional rehabilitation after stroke, including their impact on ADL.

Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The Scopus, PubMed, and EBSCO-host databases were searched for randomized controlled trials (RCTs) published from January 2015 to February 2025. Eligible studies included adult patients with stroke undergoing gamified digital interventions. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklist, and risk of bias was evaluated using the Cochrane RoB-2 tool.

Results: Twelve RCTs with 544 participants were included. The interventions employed computer-based programs, virtual reality systems, and mobile applications. The most common gamification elements were progression, feedback, levels, challenges, and points. Seven trials reported significant improvements in attentional performance, whereas five showed no measurable benefits. Only two studies demonstrated significant improvements in ADL. Safety outcomes were favorable, with mild adverse events (transient dizziness and ocular fatigue) reported in one trial.

Conclusion: Gamification-based digital health interventions are safe, feasible, and show promise in enhancing attention after stroke. However, heterogeneity, small sample sizes, and short intervention durations limit generalizability. Large-scale multicenter RCTs with standardized protocols and long-term follow-up are needed to establish clinical value.

Purpose: This study evaluated the effectiveness of evidence-based continuous quality improvement strategies in reducing peripherally inserted central catheter complications among premature infants in a tertiary neonatal intensive care unit.

Patients and methods: A retrospective cohort analysis was conducted on 722 premature infants requiring peripherally inserted central catheter placement from January 2020 to December 2023. The control group (n=154, January-December 2020) received routine bundle care, while a multidisciplinary evidence-based nursing team implemented continuous quality improvement protocols across three intervention periods: first-year implementation (n=147, 2021), second-year refinement (n=201, 2022), and third-year optimization (n=220, 2023). Primary outcomes included total complication rates and unplanned catheter removal. Multivariate logistic regression identified independent risk factors for complications.

Results: Baseline characteristics showed comparable gestational age (31.32±4.05 to 31.98±4.21 weeks, P=0.419) and insertion timing across groups. Total complication rates demonstrated progressive reduction from 46.10% in controls to 32.65% in year 1, 19.90% in year 2, and 15.45% in year 3 (χ²=51.214, P<0.001), representing a 66.5% overall reduction. Unplanned removal rates decreased from 24.03% to 11.82% (χ²=13.128, P=0.004). Multivariate logistic regression analysis revealed routine care (adjusted OR=4.707, 95% CI: 2.861-7.742, P<0.001) and first-year implementation (adjusted OR=2.672, 95% CI: 1.595-4.477, P<0.001) as independent risk factors, while higher gestational age was protective (adjusted OR=0.876, 95% CI: 0.837-0.916, P<0.001).

Conclusion: Implementation of evidence-based continuous quality improvement strategies achieved substantial and sustained reductions in peripherally inserted central catheter complications among premature infants, supporting systematic adoption of multidisciplinary approaches to optimize vascular access outcomes in vulnerable neonatal populations.

Background: Acupuncture therapy is widely utilized globally to treat irritable bowel syndrome (IBS) with promising outcomes. However, in recent years, bibliometric analyses have yet to be performed. Consequently, this paper aims to comprehensively analyze the literature from the past 20 years using CiteSpace, VOSviewer, and Excel to identify research hotspots and predict future trends.

Methods: A bibliometric search on acupuncture therapy for IBS was conducted using the Web of Science Core Collection, covering 2004 to 2024. The bibliometric analysis included examining annual publications, countries, authors, cited authors, institutions, journals, cited journals, cited references, and keywords. CiteSpace 6.3.R1, VOSviewer 1.6.18, and Microsoft Excel 2021 facilitated this analysis by creating a knowledge mapping.

Results: A total of 128 papers were included in the final analysis, revealing a general upward trend in annual publications. The predominant type of literature identified was articles. China exhibited the highest centrality of published articles. Wu Huangan emerged as the most prolific author, while Drossman DA had the most cited publications. The Shanghai University of Traditional Chinese Medicine was identified as the most productive institution. Evidence-based Complementary and Alternative Medicine published the most relevant articles, whereas Gastroenterology was the most frequently cited journal. The article Pei LX (2020) was the most cited reference, and Chao GQ (2014) had the highest centrality among cited references. Keyword analysis identified research hotspots focused on clinical symptoms (especially abdominal pain) and gut-related mechanisms. Furthermore, keyword burst analysis revealed that visceral hypersensitivity and gut microbiota are key research frontiers, indicating recent surges in scientific interest.

Conclusion: This study analyzed the literature on acupuncture therapy for IBS by bibliometric methods, revealing its current status and research hotspots and providing a reference for researchers to conduct more in-depth studies in the field.

Uric acid nephropathy (UAN) represents a critical and multifactorial renal disorder closely linked to hyperuricemia, inflammation, and gut microbiota dysregulation. Recent advances have revealed the pivotal role of the gut-kidney axis in modulating urate metabolism, immune activation, and oxidative stress. This review synthesizes emerging preclinical and clinical evidence to construct an integrative framework for understanding UAN, highlighting both crystal-dependent and crystal-independent mechanisms that drive tubular injury and fibrosis. Accumulating data underscore the reciprocal crosstalk between renal dysfunction and gut dysbiosis, mediated by microbial metabolites such as short-chain fatty acids (SCFAs), indoxyl sulfate, and p-cresol sulfate. We further evaluate therapeutic interventions targeting the gut-kidney axis-including probiotics, synbiotics, postbiotics, fecal microbiota transplantation (FMT), and engineered microbial therapies-which have shown promise in restoring microbial balance and improving urate handling. By integrating multi-omics profiling with systems biology, this review proposes a precision-medicine roadmap that leverages microbiome signatures and metabolic phenotyping for risk stratification and personalized intervention. Moreover, we emphasize the need for supportive regulatory frameworks and interdisciplinary collaboration to enable the clinical translation of microbiota-based strategies. Collectively, this work provides a strengthened conceptual foundation for microbiome-informed prevention and treatment of uric acid-related kidney disease.

Background: Systematic reviews and meta-analyses play a key role in evidence-based medical decision-making. However, single authorship in these studies may affect the quality and validity of the results. This study aimed to investigate the trends and characteristics of these articles.

Methods: A bibliometric analysis was conducted using the Scopus database to identify systematic reviews and meta-analyses published between 2000 and 2023Article-, author-, and journal-level parameters were assessed. The study followed PRISMA 2020 and PRISMA-S guidelines to ensure transparency in search, screening, and reporting.

Results: Two thousand five hundred four articles were identified, with a trend of increasing publication. The average citations per document was 44. Two-thirds of the journals are hosted in Q1 and Q2. Also, 25% of the authors had more than one systematic review or meta-analysis article. Some authors had published several articles in the same journal. The United States, the United Kingdom, and Saudi Arabia had the highest contributions to these articles. Male authors accounted for 65.33% and female authors for 34.66%.

Conclusion: The persistence of single-authored reviews contradicts international guidelines that emphasize collaborative authorship for methodological rigor. Given that systematic reviews directly inform clinical guidelines and patient care, reinforcing collaborative authorship, along with stricter editorial standards and clearer ethical guidance, is essential to preserve the credibility and reliability of evidence synthesis in evidence-based medicine.

Background: The Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health and shares several clinical features with ulcerative colitis (UC). However, the existence of a common pathological mechanism between COVID-19 and UC remains uncertain. Additionally, effective treatment strategies for UC patients infected with COVID-19 are not well established. In this study, we investigate the potential shared pathogenesis of UC and COVID-19 and explore possible therapeutic regimens through bioinformatics and systems biology approaches.

Methods: Common differentially expressed genes (DEGs) were extracted from the COVID-19 and ulcerative colitis (UC) datasets for functional enrichment, pathway analysis. The EnrichR database was used to predict potential transcription factors (TFs), microRNAs (miRNAs), and related drugs and diseases, enabling the construction of a regulatory network for both conditions.

Results: We identified 115 significant common DEGs, with 11 high-confidence hub genes-including IFI16, IL-33, and CD55-implicated in innate immunity and inflammatory regulation. Pathway analysis revealed enrichment in interferon signaling, neutrophil activation, and cytokine-mediated responses. Regulatory network reconstruction highlighted miR-155-5p and transcription factors (eg, STAT1) as key regulators. Drug repurposing efforts prioritized retinoic acid, cyclosporine, and TD-139, which target these shared mechanisms.

Conclusion: This study reveals robust molecular commonalities between COVID-19 and UC, highlighting dysregulated immune pathways and regulatory networks as shared mechanisms. We propose novel drug-repurposing candidates supported by network-based evidence, offering potential therapeutic strategies for patients with comorbid COVID-19 and UC.

Objective: The usability questionnaire of the English version of the virtual reality system was localized to verify its reliability and validity in ICU patients, providing a scientific assessment tool for clinical practice.

Methods: The Brislin translation model was adopted to complete the cross-cultural adaptation of the scale. A total of 331 ICU patients from a tertiary hospital in Zhengzhou City were included through convenience sampling for item analysis, validity and reliability tests.

Results: The Chinese version of the scale consists of 3 dimensions and a total of 9 items. The Cronbach's α coefficient of the total scale was 0.821 and the split-half reliability was 0.782. The content validity index at the item level ranged from 0.833 to 1.000, and the average content validity index at the scale level was 0.978. Exploratory factor analysis extracted three common factors, with a cumulative variance contribution rate of 67.017%. The factor loadings of each item ranged from 0.609 to 0.876, and no items were deleted. Confirmatory factor analysis showed that the standardized path coefficients of all items were within the acceptable range. These results indicate that the adapted questionnaire is a psychometrically sound instrument.

Conclusion: The Chinese version of VRSUQ has good reliability, validity and cultural adaptability. It not only fills the gap of a VR system usability assessment tool that is both culturally and clinically applicable for ICU patients in China, but also overcomes the limitations of existing international tools. Proven tools can be directly applied to clinical practice to guide the optimization of VR intervention measures, thereby enhancing patient experience and intervention effectiveness. In the future, its universality needs to be verified through multi-center research.

Purpose: Exercise-based cardiac rehabilitation (CR) is internationally recognized as an essential component of secondary prevention for coronary heart disease (CHD). However, participation in China remains low. Although barriers to CR have been extensively reported worldwide, China's regional disparities and distinct exercise traditions create context-specific constraints and opportunities. This study conducted a systematic review using the updated Consolidated Framework for Implementation Research (CFIR) 2.0 to identify multi-level factors that facilitate or impede CR implementation within Chinese healthcare systems.

Methods: Seven major databases were searched through October 2024 for studies examining determinants of participation in, or delivery of, exercise-based CR among CHD patients or clinical staff. Study quality was evaluated using the Mixed Methods Appraisal Tool, and extracted findings were organized according to the five CFIR 2.0 domains.

Results: Twenty studies met the inclusion criteria, and several influences distinctive to the Chinese context were identified. For example, hospitals in better-resourced provinces provided more complete and structured CR services, whereas those in less developed regions faced fragmented referral pathways and severely limited rehabilitation infrastructure. Cultural expectations further shaped engagement, with many patients favoring medication-based management over exercise, despite traditional practices such as Tai Chi and Baduanjin being viewed positively and offering a culturally acceptable entry point for rehabilitation. Digital tools, including mobile-health platforms and wearable devices, increasingly supported participation, particularly where in-person services were difficult to access. At the institutional level, CR implementation was more successful in centers with established multidisciplinary teams and stable funding, while hospitals lacking such support struggled to maintain consistent programs.

Conclusion: By clarifying how structural, institutional, and patient-level barriers interact to restrict cardiac rehabilitation in China, the review emphasizes that nationwide advancement will require policy reinforcement, better-trained rehabilitation teams, and implementation approaches tailored to patient needs.