Xiaoling Gao

Objectives: To characterize the real-world safety profile of fezolinetant, a neurokinin-3 receptor antagonist approved for the treatment of menopausal vasomotor symptoms, using adverse event reports from the WHO VigiAccess database. Methods: Adverse event reports were retrieved from VigiAccess. Disproportionality analyses using reporting odds ratio, proportional reporting ratio, information component, and empirical Bayes geometric mean were applied to identify safety signals. A signal was defined as meeting all four criteria (reporting odds ratio [ROR] lower 95% CI > 1, proportional reporting ratio ≥ 2 with χ² ≥ 4, IC025 > 0, EBGM05 > 2). Results: A total of 1,091 individual case safety reports comprising 2,143 adverse events were identified, with most reports in women (96.7%) aged 45-64 years (42.16%) and a marked increase in 2024 (n=1,037). Forty-two preferred terms were identified and consistently detected across all methods. The strongest signals included menopausal symptoms (ROR=139.86, 95% CI=75.09-260.53) and facial discomfort (ROR=104.90, 95% CI=33.77-325.87). Liver-related abnormalities showed consistent signals, including increased alanine aminotransferase (ROR=20.60), aspartate aminotransferase (ROR=22.95), and bilirubin (ROR=12.52), suggesting a clustered hepatic signal. Neurological and psychiatric events included insomnia, headache, dizziness, migraine, brain fog, and sleep disorder, whereas gastrointestinal symptoms such as diarrhea and abdominal pain were also observed. Vasomotor symptom-related terms likely reflected the underlying disease rather than treatment effects. Conclusions: This exploratory analysis found that fezolinetant’s real-world safety profile was broadly consistent with phase 3 trials, with efficacy in reducing menopausal vasomotor symptoms. Disproportionality signals mainly involved liver and neurological events. These findings do not reflect absolute risk or incidence and should be considered hypothesis-generating. In view of its established benefit, they support a balanced benefit–risk assessment for clinical use.

1. Obstructive sleep apnea (OSA) is a highly prevalent sleep-related breathing disorder affecting nearly one billion adults worldwide [1,2]. Beyond causing daytime sleepiness, OSA is frequently ass...

Background: Obstructive sleep apnea (OSA) shows marked variability in cardiovascular and mortality risk. The Prognostic Nutritional Index (PNI), derived from serum albumin and lymphocyte count, reflects nutritional and inflammatory status, but its relevance in OSA populations remains unclear. Methods: We analyzed 10,229 adults at risk for OSA from NHANES 2005– 2008 and 2015– 2018, with mortality follow-up through 2019 (median 5.08 years). Survey-weighted Cox models examined associations between PNI and all-cause and cardiovascular mortality. Dose-response relationships were assessed using restricted cubic splines, and discrimination was evaluated with time-dependent ROC analyses. Subgroup and sensitivity analyses assessed robustness. Additionally, 555 polysomnography-confirmed OSA patients were analyzed cross-sectionally to examine associations between PNI and disease severity. Results: During follow-up, 1025 all-cause and 287 cardiovascular deaths occurred. Higher PNI was associated with lower all-cause (adjusted HR 0.59, 95% CI 0.47– 0.75) and cardiovascular mortality (HR 0.57, 95% CI 0.36– 0.89), with significant dose–response trends and nonlinear associations for all-cause mortality. Associations were consistent across subgroups and sensitivity analyses. PNI showed better discrimination for mortality than its individual components (12-month AUC 0.74). In the clinical cohort, higher PNI was associated with reduced odds of severe OSA (OR 0.864, 95% CI 0.833– 0.896) and lower apnea-hypopnea index. Conclusion: Lower PNI is independently associated with higher mortality risk among individuals at risk for OSA and with greater disease severity in confirmed OSA. These findings highlight the potential clinical relevance of nutritional and immune status in OSA populations. However, the temporal and causal relationships between PNI, OSA severity, and mortality require further investigation.

Background Lung cancer is one of the malignant tumors with high morbidity and mortality worldwide. Nuclear factor E2-ralated factor 2 (Nrf2), a critical antioxidant transcription factor, has been identified to play a significant role in the pathogenesis, progression and chemoresistance of lung cancer through its dysregulated activation. The present investigation sought to enhance our understanding of the global research landscape concerning Nrf2 in lung cancer by employing a bibliometric methodology. Methods The present study retrieved relevant articles and reviews concerning Nrf2 in lung cancer from the Web of Science Core Collection and Scopus databases. A comprehensive bibliometric analysis was conducted utilizing a suite of tools including Microsoft Excel, Python, CiteSpace, VOSviewer, R (bibliometrix), and Charticulator to evaluate various aspects such as publication productivity, contributing nations, affiliated institutions, prominent authors, influential journals, co-cited references, and thematic keywords. Results The study encompassed 1931 publications, showing a marked rise in citations from 2002 to 2025. China dominated the publication landscape, with several leading institutions contributing. Professors Masayuki Yamamoto and Shyam Biswal were identified as key contributors. Cancer Research was the most prolific journal. Nrf2 played a central role in lung cancer research, with research hotspots evolving from basic studies to clinical treatment strategies and increasing interest in specific lung cancer subtypes, reflecting the multidimensional and interdisciplinary development of the field. Conclusion Research on Nrf2 in lung cancer has shifted from basic cell typing to studies of oxidation and programmed cell death, and it is time to dissect upstream regulators and create targeted Nrf2 modulators for personalized treatment.

Background: The relationship between air pollution and lung cancer has attracted considerable attention from researchers worldwide. To systematically assess the scholarly landscape and pinpoint research fronts, this study employs bibliometric analysis to delineate global trends, collaborative networks, and key publications within this field. Methods: Publications from 1990 to 2025 were extracted from Web of Science Core Collection and Scopus databases. Bibliometric tools including VOSViewer, Citespace, and Bibliometrix R were used to examine trends, key contributors, research themes, and prominent journals. Results: Among 4,238 publications, citation rates rose significantly. China produced the most publications, with leading institutions such as Harvard University and the Chinese Academy of Sciences. Key researchers included Lan Q, Rothman N, and Vermeulen R. Major journals were Environmental Health Perspectives and Atmospheric Environment. Frequently used keywords like “Lung Cancer” and “Particulate Matter” indicate core themes, while emerging terms such as “Covid-19” and “Machine Learning” reflect evolving interests. Conclusion: Fine particulate matter is an established environmental risk factor for lung cancer, and research on polycyclic aromatic hydrocarbons and asbestos remains active. The field has shifted from exposure assessment to mechanistic investigations focusing on oxidative stress, gene expression, and machine learning applications, defining key future research directions.

Background: Obstructive sleep apnea (OSA) in children is linked to cognitive impairment, which is further aggravated by fragmented sleep, intermittent hypoxia, and comorbid attention deficit hyperactivity disorder (ADHD), often resulting in poor academic performance, behavioral problems, and delayed neurodevelopment. Methods: A bibliometric and scientometric analysis was conducted using Web of Science Core Collection (WoSCC) and Scopus databases (1983–2025). After exclusion of non-article records and duplicates, 1,610 studies were included. CiteSpace, VOSviewer, and the R-based Bibliometrix package were employed to analyze publication trends, authorship, institutional collaborations, co-citations, and keyword evolution. Results: Since 2010, scholarly attention to pediatric obstructive sleep apnea and its cognitive implications has grown rapidly, with research output increasing at an annual rate of 11.96%. The United States, China, and several European countries stand out as major contributors, both in terms of publications and international collaboration. Prominent academic centers—such as Harvard University, the University of Michigan, and the University of Chicago—serve as key institutional hubs. Among the most influential contributors to the field are David Gozal and Leila Kheirandish-Gozal, while leading journals include Sleep Medicine and the Journal of Clinical Sleep Medicine . Keyword mapping highlights the central focus on “obstructive sleep apnea,” “children,” and “sleep-disordered breathing,” alongside diagnostic and treatment terms such as “polysomnography” and “adenotonsillectomy.” Notably, there is growing emphasis on cognitive and behavioral aspects, including “cognition,” “behavior,” and “ADHD,” as well as comorbidities like “obesity” and “Down syndrome.” Recent clusters underscore advances in artificial intelligence (AI) and machine learning (ML) based models using oximetry, electrocardiogram (ECG), and acoustic data, enabling early detection and supporting precision medicine approaches. Conclusion: The relationship between pediatric obstructive sleep apnea and neurocognitive development has gained significant attention, with recent research focusing on cognitive outcomes and emerging technologies. While conventional treatments remain important, their limited impact on cognitive recovery underscores the need for early diagnosis and personalized therapies. Advances in artificial intelligence and machine learning are improving diagnostic accuracy, enabling earlier interventions, and supporting neurocognitive function in affected children. These developments reflect a shift toward precision-based, tailored care rather than one-size-fits-all treatments.

Emerging evidence has revealed a strong association between obstructive sleep apnea (OSA) and aging. Considering the critical role of the cardiovascular system, this review explores the key mechanisms linking OSA to cardiovascular aging through a focus on chronic intermittent hypoxia (CIH) -induced oxidative stress and chronic inflammation. Specifically, we examine six key pathways: (1) cellular senescence, (2) mitochondrial dysfunction, (3) metabolic dysregulation, (4) telomere attrition, (5) impaired intercellular communication, and (6) adipose tissue senescence. These insights provide a foundation for identifying novel interventions and therapeutic targets to mitigate or even reverse cardiovascular aging.

Background: Asthma is a chronic respiratory disease influenced by genetic and environmental factors. Emerging evidence highlights epigenetics as a key regulatory mechanism in asthma development.Objective: This research aimed to summarize current evidence on immune–epigenetic mechanisms in asthma and to identify global research hotspots through bibliometric analysis.Methods: A systematic search was conducted in the Web of Science Core Collection(WoSCC) and Scopus databases for studies published between 1980 and July 2025. Following PRISMA guidelines, duplicate removal and quality control were performed. Eligible articles were analyzed using CiteSpace, VOSviewer, and the R bibliometrix package to evaluate publication trends, countries, institutions, authors, journals, co-cited references, and keyword clusters.Results: A total of 4,020 unique publications were included. By utilizing data from both the WoSCC and Scopus, research output has risen markedly since 2010, with the United States and China leading in productivity and collaboration. Harvard University and the University of California System emerged as central institutions, while influential authors included Ian M. Adcock, Juan C. Celedón, and Peter J. Barnes. Leading journals, like Clinical Epigenetics and the Journal of Allergy and Clinical Immunology, have seen a steady increase in interdisciplinary research contributions over the years. Through keyword clustering, we identified four major research hotspots: immune and inflammatory mechanisms, epigenetic and regulatory mechanisms, environmental exposures and gene–environment interactions, and epigenetic therapies and biomarkers for precision medicine.Conclusion: Epigenetic research in asthma is rapidly expanding, with increasing international collaboration. Future efforts should focus on translating mechanistic insights into clinical applications by validating biomarkers, refining patient stratification, and advancing epigenetic-based therapeutic strategies.