bluuebunny/crossref_metadata_2025 huggingface dataset:
Modulation of regional carbon uptake by AMOC and alkalinity changes in the subpolar North Atlantic under a warming climate
Authors: Zhang Qi , Ito Takamitsu , Bracco Annalisa
Published: April 2024

The slowdown of the Atlantic Meridional Overturning Circulation (AMOC) and associated consequences on ocean carbon uptake could have large implications for the Earth's climate system and its global carbon cycle. This study analyzes ten Earth System Models from the Coupled Model Intercomparison Project Phase 6 (CMIP6) and reveals that the regional carbon uptake in the subpolar North Atlantic under a high CO2 emission scenario moderately correlates with the decline in AMOC at 40°N. AMOC transports warm and salty subtropical waters to the subpolar regions. Models with stronger AMOC slowdown generally exhibit weaker surface warming and larger decline of surface salinity and alkalinity. We consider two plausible mechanisms linking the AMOC slowdown to the decline of regional CO2 uptake: the reduction in surface alkalinity and diminished subduction. The decline of surface salinity and alkalinity reduces the ocean's capacity to buffer acids leading to a reduced CO2 uptake. This important contribution is unique to the North Atlantic. Diminished convective mixing and subduction of surface water can further decrease the downward transport of anthropogenic carbon, as also shown in previous research. The centennial trends of pCO2 are decomposed into four components driven by temperature, salinity, alkalinity and dissolved inorganic carbon, revealing that alkalinity and dissolved inorganic carbon are both significant contributors. The alkalinity-driven pCO2 essentially follows surface salinity, establishing the linkage between AMOC slowdown and alkalinity decline. Our results indicate that alkalinity changes are important for the interplay between AMOC and the regional carbon sequestration ability across the late 20th and the entirety of the 21st century in the subpolar North Atlantic.
Adipocentric origin of the common cardiometabolic complications of obesity in the young up to the very old: pathophysiology and new therapeutic opportunities
Authors: Sarzani Riccardo , Landolfo Matteo , Di Pentima Chiara , Ortensi Beatrice , Falcioni Paolo , Sabbatini Lucia , Massacesi Adriano , Rampino Ilaria , Spannella Francesco , Giulietti Federico
Published: April 2024

Obesity is a multifactorial chronic disease characterized by an excess of adipose tissue, affecting people of all ages. In the last 40 years, the incidence of overweight and obesity almost tripled worldwide. The accumulation of “visceral” adipose tissue increases with aging, leading to several cardio-metabolic consequences: from increased blood pressure to overt arterial hypertension, from insulin-resistance to overt type 2 diabetes mellitus (T2DM), dyslipidemia, chronic kidney disease (CKD), and obstructive sleep apnea. The increasing use of innovative drugs, namely glucagon-like peptide-1 receptor agonists (GLP1-RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2-i), is changing the management of obesity and its related cardiovascular complications significantly. These drugs, first considered only for T2DM treatment, are now used in overweight patients with visceral adiposity or obese patients, as obesity is no longer just a risk factor but a critical condition at the basis of common metabolic, cardiovascular, and renal diseases. An adipocentric vision and approach should become the cornerstone of visceral overweight and obesity integrated management and treatment, reducing and avoiding the onset of obesity-related multiple risk factors and their clinical complications. According to recent progress in basic and clinical research on adiposity, this narrative review aims to contribute to a novel clinical approach focusing on pathophysiological and therapeutic insights.
Age-related changes in static balance in older women aged in their early sixties to their late eighties: different aging patterns in the anterior–posterior and mediolateral directions
Authors: Sasagawa Shun , Arakawa Ai , Furuyama Aimi , Matsumoto Yasuo
Published: April 2024

Objective

The aim of this study was to cross-sectionally investigate how static balance changes throughout the aging process in older women aged from their early sixties to their late eighties.

Methods

Forty-six older women (aged 62–89 years) were requested to stand barefoot and quietly on a force platform for 30 s with their eyes either open or closed. During the trials, the position of the center of foot pressure (CoP) and the acceleration of the body’s center of mass (ACC) were measured. The root mean square (RMS) of the CoP and ACC values was calculated to evaluate the amplitude of postural sway and the level of regulatory activity, respectively. The mean power frequency of the ACC was also calculated to represent the temporal characteristics of regulatory activity.

Results

In the anterior–posterior direction, there was no significant relationship between the RMS of CoP and the participants’ age, whereas the RMS of ACC significantly increased with increasing age. In the mediolateral direction, however, the RMS of CoP significantly increased with increasing age, whereas the RMS of ACC did not change with age. The mean power frequency of ACC did not exhibit any age-related change in either the anterior–posterior or the mediolateral direction.

Conclusion

The results indicate that static balance in older women aged in their early sixties to their late eighties exhibits distinctly contrasting aging patterns between the anterior–posterior and mediolateral directions. To prevent falls in older women, it is necessary to elucidate the physiological mechanisms responsible for the increase in mediolateral sway that occurs throughout old age.
Association between Life’s Essential 8 and cognitive function: insights from NHANES 2011–2014
Authors: Liang Kangni , Zhang Xiaoling
Published: April 2024

Introduction

Life’s Essential 8 (LE8) is prompted by the American Heart Association (AHA) to assess cardiovascular health. The association between LE8 and cognitive function in America is unknown. Our study was to investigate the association of LE8 with cognitive function in general adults.

Materials and methods

A total of 2,301 participants were enrolled in the National Health and Nutrition Examination Surveys (NHANES). LE8 scores (range 0–100) were obtained from measurements based on American Heart Association definitions, divided into health behavior and health factor scores. Cognitive function was assessed by three tests including the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD), Animal fluency test (AFT), and Digit Symbol Substitution test (DSST). The multivariable linear regression analysis explored the associations between LE8 and cognitive function. Smooth curve fitting was explored using restricted cubic splines. The inflection point was determined by the two-piecewise linear regression.

Results

In the multivariable linear regression model with full adjustment for confounding variables, AFT scores were 1.2 points higher in participants with LE8 scores >80 than in those with LE8 scores <50 (high LE8 score group: β = 1.20, 95% CI 0.37, 2.03), and 3.32 points higher in DSST (high LE8 score group: β = 3.32, 95% CI 1.24, 5.39). Although high LE8 scores show a Negative association with high CERAD, we found a significant association between higher LE8 scores and higher CERAD when LE8 scores were higher than 82.5 (β = 0.21 95%CI 0.04, 0.39, p-value = 0.0179).

Conclusion

Our study highlighted a positive association between Life’s Essential 8 and cognitive function in older adults.
Interrater reliability of the Fugl-Meyer Motor assessment in stroke patients: a quality management project within the ESTREL study
Authors: Wiesner Karin , Schwarz Anne , Meya Louisa , Kaufmann Josefin Emelie , Traenka Christopher , Luft Andreas Rüdiger , Held Jeremia Philipp Oskar , Engelter Stefan
Published: April 2024

Introduction

The Fugl-Meyer Motor Assessment (FMMA) is recommended for evaluating stroke motor recovery in clinical practice and research. However, its widespread use requires refined reliability data, particularly across different health professions. We therefore investigated the interrater reliability of the FMMA scored by a physical therapist and a physician using video recordings of stroke patients.

Methods

The FMMA videos of 50 individuals 3 months post stroke (28 females, mean age 71.64 years, median National Institutes of Health Stroke Scale score 3.00) participating in the ESTREL trial (Enhancement of Stroke Rehabilitation with Levodopa: a randomized placebo-controlled trial) were independently scored by two experienced assessors (i.e., a physical therapist and a physician) with specific training to ensure consistency. As primary endpoint, the interrater reliability was calculated for the total scores of the entire FMMA and the total scores of the FMMA for the upper and lower extremities using intraclass correlation coefficients (ICC). In addition, Spearman’s rank order correlation coefficients (Spearman’s rho) were calculated for the total score and subscale levels. Secondary endpoints included the FMMA item scores using percentage agreement, weighted Cohen’s kappa coefficients, and Gwet’s AC1/AC2 coefficients.

Results

ICCs were 0.98 (95% confidence intervals (CI) 0.96–0.99) for the total scores of the entire FMMA, 0.98 (95% CI 0.96–0.99) for the total scores of the FMMA for the upper extremity, and 0.85 (95% CI 0.70–0.92) for the total scores of the FMMA for the lower extremity. Spearman’s rho ranged from 0.61 to 0.94 for total and subscale scores. The interrater reliability at the item level of the FMMA showed (i) percentage agreement values with a median of 77% (range 44–100%), (ii) weighted Cohen’s kappa coefficients with a median of 0.69 (range 0.00–0.98) and (iii) Gwet’s AC1/AC2 coefficients with a median of 0.84 (range 0.42–0.98).

Discussion and conclusion

The FMMA appears to be a highly reliable measuring instrument at the overall score level for assessors from different health professions. The FMMA total scores seem to be suitable for the quantitative measurement of stroke recovery in both clinical practice and research, although there is potential for improvement at the item level.
Case report: Chronic inflammatory demyelinating polyneuropathy superimposed on Charcot–Marie-tooth type 1A disease after SARS-CoV-2 vaccination and COVID-19 infection
Authors: Li Da , Yu Hu , Zhou Min , Fan Weinv , Guan Qiongfeng , Li Li
Published: April 2024

Background

There is growing evidence that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) or COVID-19 infection is associated with the development of immune mediated neuropathies like chronic inflammatory demyelinating polyneuropathy (CIDP), but the impact of SARS-CoV-2 vaccination and COVID-19 infection on genetic disorders such as Charcot–MarieTooth (CMT) remains unclear.

Case presentation

A 42-year-old male with occulted CMT neuropathy type lA (CMT1A) who developed limb numbness and weakness after the second SARS-CoV-2-vaccination was confirmed by identifying characteristic repeats in the p11.2 region of chromosome 17. Due to the progressive deterioration of muscle strength over 8 weeks, limb atrophy, moderately elevated protein counts in the cerebrospinal fluid, and significant improvement with intravenous human immunoglobulin, which were characteristic of acquired inflammatory neuropathies, he was eventually diagnosed with CIDP superimposed on CMT1A. However, after a three-month plateau, the patient contracted COVID-19, which led to repeated and worsening symptoms of limb weakness and atrophy, thus was diagnosed with a recurrence of CIDP and treated with Intravenous immunoglobulin and methylprednisolone 500 mg/d for 5 consecutive days, followed by oral prednisone and mycophenolate mofetil tablets. On 2 month follow-up, he exhibited remarkable clinical improvement and could walk independently with rocking gait. After 1 year of follow-up, the patient’s condition was stable without further change.

Conclusion

Our case indicates that CMT1A can deteriorate after SARS-CoV-2 vaccination. Thus, SARS-CoV-2 vaccination should be considered a potential predisposing factor for CMT1A worsening. The possible superposition of CMTIA and CIDP in the context of SARS-CoV-2 infection or immunity suggests that any clinical exacerbation in patients with CMT1A should be carefully evaluated to rule out treatable superposition inflammation. In addition, electrophysiological and imaging examination of the proximal nerves, such as the axillary nerve, is helpful for the diagnosis of CIDP.
Effect of Dl-3-n-Butylphthalide on olfaction in rotenone-induced Parkinson’s rats
Authors: Wang Jiawei , Li He , Wang Canran , Li Dayong , Zhang Yong , Shen Meichan , Xu Xiangdong , Wu Tong
Published: April 2024

Background

Parkinson’s disease (PD) is the second most common neurodegenerative disease after Alzheimer’s disease. Olfactory dysfunction (OD) is an important nonmotor feature of PD. Dl-3-n-Butylphthalide (NBP) is a synthetic compound isolated from Apium graveolens seeds. The present study was conducted to investigate the effect of NBP on olfaction in rotenone-induced Parkinson’s rats to explore the mechanism and pathway of OD in PD.

Methods

The PD model was established using rotenone-induced SD rats, divided into blank control, model, and treatment groups. A sham group was also established, with 10 rats in each group. The treatment group was given NBP (1 mg/kg, 10 mg/kg, and 100 mg/kg, dissolved in soybean oil) intragastrically for 28 days. Meanwhile, the control group rats were given intra-gastrically soybean oil. After behavioral testing, all rats were executed, and brain tissue was obtained. Proteomics and Proteomic quantification techniques (prm) quantification were used to detect proteomic changes in rat brain tissues.

Results

Compared with the control group, the model group showed significant differences in behavioral tests, and this difference was reduced after treatment. Proteomics results showed that after treatment with high-dose NBP, there were 42 differentially expressed proteins compared with the model group. Additionally, the olfactory marker (P08523) showed a significant upregulation difference. We then selected 22 target proteins for PRM quantification and quantified 17 of them. Among them, the olfactory marker protein was at least twofold upregulated in the RTH group compared to the model group.
Exploring research hotspots and future directions in neural tube defects field by bibliometric and bioinformatics analysis
Authors: Cao Rui , Su Yanbing , Li Jianting , Ao Ruifang , Xu Xiangchao , Liang Yuxiang , Liu Zhizhen , Yu Qi , Xie Jun
Published: April 2024

Background

Neural tube defects (NTDs) is the most common birth defect of the central nervous system (CNS) which causes the death of almost 88,000 people every year around the world. Much efforts have been made to investigate the reasons that contribute to NTD and explore new ways to for prevention. We trawl the past decade (2013–2022) published records in order to get a worldwide view about NTDs research field.

Methods

7,437 records about NTDs were retrieved from the Web of Science (WOS) database. Tools such as shell scripts, VOSviewer, SCImago Graphica, CiteSpace and PubTator were used for data analysis and visualization.

Results

Over the past decade, the number of publications has maintained an upward trend, except for 2022. The United States is the country with the highest number of publications and also with the closest collaboration with other countries. Baylor College of Medicine has the closest collaboration with other institutions worldwide and also was the most prolific institution. In the field of NTDs, research focuses on molecular mechanisms such as genes and signaling pathways related to folate metabolism, neurogenic diseases caused by neural tube closure disorders such as myelomeningocele and spina bifida, and prevention and treatment such as folate supplementation and surgical procedures. Most NTDs related genes are related to development, cell projection parts, and molecular binding. These genes are mainly concentrated in cancer, Wnt, MAPK, PI3K-Akt and other signaling pathways. The distribution of NTDs related SNPs on chromosomes 1, 3, 5, 11, 14, and 17 are relatively concentrated, which may be associated with high-risk of NTDs.

Conclusion

Bibliometric analysis of the literature on NTDs field provided the current status, hotspots and future directions to some extant. Further bioinformatics analysis expanded our understanding of NTDs-related genes function and revealed some important SNP clusters and loci. This study provided some guidance for further studies. More extensive cooperation and further research are needed to overcome the ongoing challenge in pathogenesis, prevention and treatment of NTDs.
Associations between single and multiple dietary vitamins and the risk of periodontitis: results from NHANES 2009–2014
Authors: Liang Feizhao , Lu Mei , Zhou Yanping
Published: April 2024

Background

Periodontitis is a prevalent inflammatory periodontal disease that has an impact on the overall quality of life. Although several studies have indicated an association between individual vitamin intake and periodontitis risk, the associations of the multivitamins with periodontitis risk remain unclear.

Aim

This study aimed to explore the joint effect of multivitamins (including vitamin A, vitamin B1, vitamin B2, vitamin B6, vitamin B12, vitamin C, vitamin D, vitamin E, and vitamin K) on periodontitis.

Methods

For this cross-sectional study, data were collected from participants aged ≥ 30 years in the National Health and Nutrition Examination Surveys 2009–2014 (n = 9,820). We employed weighted multivariate logistic regression models to evaluate the single association between individual vitamin intakes and periodontitis, and Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS) regression, and quantile g-computation (qgcomp) models to assess the joint effect of nine vitamins on periodontitis.

Results

The overall prevalence of periodontitis was approximately 35.97%. After adjustment of covariates, vitamin B6 [odds ratio (OR) = 0.82, 95% confidence interval (CI): 0.72–0.94] and vitamin E (OR = 0.79, 95%CI: 0.69–0.92) were negatively related to the likelihood of developing periodontitis, respectively. The result of three models indicated that, mixture of vitamin A, vitamin B1, vitamin B2, vitamin B6, vitamin B12, vitamin C, vitamin D, vitamin E, and vitamin K had a significant negative combined effect on the risk of periodontitis. In the BKMR model, when all remaining vitamins were at their median levels, the periodontitis risk decreased with increased concentration levels of vitamin E and vitamin B2. WQS analysis indicated the highest weighted chemical was vitamin E, followed by vitamin B12 and vitamin D. In the qgcomp model, vitamin E received the highest negative weights for the periodontitis risk, followed by vitamin B2 and vitamin D, respectively.

Conclusion

Both dietary vitamin B6 and vitamin E were associated with decreased odds of periodontitis. Additionally, the mixture-exposed analyses consistently showed the negative correlations between nine dietary vitamins mixtures and periodontitis.
Adherence to an antioxidant diet and lifestyle is associated with reduced risk of cardiovascular disease and mortality among adults with nonalcoholic fatty liver disease: evidence from NHANES 1999–2018
Authors: Li Yingzi , Liu Yipin
Published: April 2024

Background

Nonalcoholic fatty liver disease (NAFLD) stands a prevalent chronic liver condition significantly influenced by oxidative stress. We investigated the unclear relationship between antioxidant-rich diet and lifestyle and cardiovascular disease (CVD) prevalence rate and mortality in adult patients with NAFLD.

Methods

This study utilized data from the National Health and Nutrition Examination Survey (NHAENS) spanning from 1999 to 2018 to investigate the association between adherence to an antioxidant-rich diet and lifestyle and the cardiovascular disease (CVD) prevalence rate and mortality in adult patients with NAFLD. The study employed the Oxidative Balance Score (OBS) to define antioxidant diet and lifestyle.

Results

Including 8,670 adult patients with NAFLD, the study revealed an inverse association between OBS and the prevalence of most CVD conditions. Fully adjusted models demonstrated that each unit increase in diet OBS, lifestyle OBS, and overall OBS corresponded to a 2, 7, and 2% reduction in all-cause mortality, respectively. In models 2, findings revealed that lifestyle Q2 and Q3 were linked to reduced cancer mortality, whereas diet and overall OBS did not exhibit an association. Additionally, Stratified analysis revealed that age (<45 years) and education level (> high school) significantly influenced the association between the OBS and the prevalence of CVD.

Conclusion

These results underscore the protective link between adherence to an antioxidant diet and lifestyle and a diminished prevalence of CVD and mortality in adults with NAFLD, particularly among younger and higher-educated populations.
Neutrophil to albumin ratio: a biomarker in non-alcoholic fatty liver disease and with liver fibrosis
Authors: Bao Banghe , Xu Shuang , Sun Peng , Zheng Liduan
Published: April 2024

Objective

Given the high prevalence of non-alcoholic fatty liver disease (NAFLD) and its potential to progress to liver fibrosis, it is crucial to identify the presence of NAFLD in patients to guide their subsequent management. However, the current availability of non-invasive biomarkers for NAFLD remains limited. Therefore, further investigation is needed to identify and develop non-invasive biomarkers for NAFLD.

Methods

A retrospective analysis was conducted on 11,883 patients admitted to the Healthcare Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2016 to December 2019 and divided into NAFLD and non-NAFLD groups. Anthropometric and laboratory examination data were collected. The correlations between variables and NAFLD were evaluated using the student’s t-test or Mann–Whitney U test and binary logistic regression analysis. The predictive ability of these variables for NAFLD was assessed using the areas under the curves (AUCs) of receiver operating characteristics.

Results

Among the included patients, 3,872 (32.58%) were diagnosed with NAFLD, with 386 (9.97%) individuals having liver fibrosis. Patients with NAFLD exhibited a higher proportion of males, elevated body mass index (BMI), and increased likelihood of hypertension, diabetes mellitus, and atherosclerosis. Logistic regression analysis identified the neutrophil to albumin ratio (NAR) as the most promising novel inflammation biomarkers, with the highest AUC value of 0.701, a cut-off value of 0.797, sensitivity of 69.40%, and specificity of 66.00% in identifying the risk of NAFLD. Moreover, NAR demonstrated superior predictive value in identifying NAFLD patients at risk of liver fibrosis, with an AUC value of 0.795, sensitivity of 71.30%, and specificity of 73.60% when NAR reached 1.285.

Conclusion

These findings highlight that the novel inflammatory biomarker, NAR, is a convenient and easily accessible non-invasive predictor for NAFLD and NAFLD with liver fibrosis.
The research progress on radiation resistance of cervical cancer
Authors: Liang Meili , Sheng Liying , Ke Yumin , Wu Zhuna
Published: April 2024

Cervical carcinoma is the most prevalent gynecology malignant tumor and ranks as the fourth most common cancer worldwide, thus posing a significant threat to the lives and health of women. Advanced and early-stage cervical carcinoma patients with high-risk factors require adjuvant treatment following surgery, with radiotherapy being the primary approach. However, the tolerance of cervical cancer to radiotherapy has become a major obstacle in its treatment. Recent studies have demonstrated that radiation resistance in cervical cancer is closely associated with DNA damage repair pathways, the tumor microenvironment, tumor stem cells, hypoxia, cell cycle arrest, and epigenetic mechanisms, among other factors. The development of tumor radiation resistance involves complex interactions between multiple genes, pathways, and mechanisms, wherein each factor interacts through one or more signaling pathways. This paper provides an overview of research progress on an understanding of the mechanism underlying radiation resistance in cervical cancer.
Human Papilloma Virus (HPV) driven oropharyngeal cancer in current or previous heavy smokers: should we look for a different treatment paradigm?
Authors: Lorini Luigi , Bossi Paolo , Psyrri Amanda , Bonomo Pierluigi
Published: April 2024

Introduction

Human papillomavirus Virus (HPV)-associated oropharyngeal squamous cell carcinoma (OSCC) has increased in incidence in recent decades and represents a heterogeneous disease entity in the context of Head and Neck Squamous Cell Carcinoma (HNSCC), in terms of disease prognosis. Treatment of locoregionally advanced OSCC is mainly based on concurrent chemoradiotherapy. Given the younger age of patients, if compared with HPV-negative counterparts, and the high cure rates, the acute- and long-term toxicity in survivors represents a field of interest. However, patient selection for de-escalation trials remains a major challenge due to the lack of robust validated prognostic indicators within the HPV-associated OSCC.

Discussion

The impact of smoking status on HPV-associated OSCC prognosis has been demonstrated in the majority of studies. However, the magnitude of the association is unclear due to variability in smoking metrics and study outcomes. Smoking status has been identified as a potential confounding factor in HPV-positive de-escalation trials. Smokers with HPV-positive OSCC have a worse prognosis in most studies than non-smokers and may require different and more aggressive therapeutic strategies.
Association between body fat distribution and age at menarche: a two sample Mendelian randomization study
Authors: Xue Peng , Wang Dan , Chen Yao , Tang Jingyi , Chen Yang , Mei Hao , Lin Cuilan , Liu Shijian
Published: April 2024

Background

Numerous studies have examined the association between obesity and age at menarche (AAM), with most focusing on traditional obesity indicators such as body mass index. However, there are limited studies that explored the connection between body fat distribution and AAM, as well as a scarcity of Mendelian randomization (MR) studies.

Methods

In this study, we conducted a two-sample MR study to evaluate the causal effects of eight body fat distribution indicators on AAM. Inverse variance weighted (IVW) method was used for primary analysis, while supplementary approaches such as MR-Egger and weighted median were also utilized. Considering that the eight exposures were highly correlated, we performed an MR Bayesian model averaging (MR-BMA) analysis to prioritize the effect of major exposure on AAM. A series of sensitivity analyses were also performed.

Results

From a range of 82–105 single nucleotide polymorphisms (SNPs) were utilized as genetic instrumental variables for each of the exposure factors. After Bonferroni correction, we found that whole body fat mass (β: −0.17; 95% CI: −0.24, −0.11), left leg fat percentage (β: −0.14; 95% CI: −0.21, −0.07), left leg fat mass (β: −0.20; 95% CI: −0.27, −0.12), left arm fat percentage (β: −0.18; 95% CI: −0.26, −0.11) and left arm fat mass (β: −0.18; 95%CI: −0.26, −0.10) were associated with decreased AAM using random effects IVW method. And the beta coefficients for all MR evaluation methods exhibited consistent trends. MR-BMA method validated that left arm fat percentage plays a dominant role in AAM.

Conclusions

Our MR study suggested that body fat has broad impacts on AAM. Obtaining more information on body measurements would greatly enhance our comprehension of pubertal development.
Safety and efficacy of East Asian herbal medicine for iron deficiency anemia in children and adolescents: a systematic review and meta-analysis
Authors: Jeong Yoon Kyoung , Kim Jae Hyun , Lee Sun Haeng , Bang Miran , Chang Gyu Tae
Published: April 2024

Background

This systematic review and meta-analysis aimed to evaluate the efficacy and safety of East Asian herbal medicine (HM) for iron deficiency anemia (IDA) in children and adolescents.

Methods

Twelve electronic databases were searched in 28 May 2023 for randomized controlled trials (RCTs) evaluating the efficacy of HM in children with IDA. The primary outcome measures for treatment included blood hemoglobin and serum ferritin levels, whereas the secondary outcomes included the total effective rate (TER), incidence of adverse events (AEs), average healing time, and hematologic indicators related to IDA. Meta-analysis was performed using Review Manager 5.4 and R studio 4.3 software, and subgroup analyses were performed according to the different groups (type of intervention and duration of treatment). The effect size measures used were the risk ratio, mean difference, and standardized mean difference with 95% confidence intervals. The risk of bias was assessed using a revised Cochrane risk of bias tool for randomized trials, and the quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation tools.

Results

The meta-analysis included 28 studies. Five studies compared the efficacy of HM alone with that of oral iron alone, whereas 23 compared the efficacy of a combination of HM and oral iron with that of oral iron alone. The meta-analysis revealed that the HM treatment group showed significant improvements in all outcome measures compared to those observed in the oral iron group. Moreover, HM significantly reduced the incidence of gastrointestinal AE, compared to that associated with oral iron. Among the 28 studies, the most commonly used HM prescription was Xingpi Yanger Granules, and the most commonly used botanical drug was Astragali Radix, followed by Atractylodis Rhizoma Alba and Angelicae Sinensis Radix.

Conclusion

This meta-analysis identified evidence of the efficacy and safety of HM in children with IDA. Compared to conventional oral iron therapy, HM improved IDA-related blood markers and TER, with fewer AEs and shorter mean healing times. However, further well-designed, large-scale clinical trials are necessary to strengthen the evidence of the efficacy and safety of botanical drugs.

Systematic Review Registration:

PROSPERO 2022 CRD42022334670. (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022334670).
Sijunzi decoction alleviates inflammation and intestinal epithelial barrier damage and modulates the gut microbiota in ulcerative colitis mice
Authors: Li Hailun , Pu Xing , Lin Yongtao , Yu Xinxin , Li Jing , Bo Lin , Wang Hongwu , Xu Yong , Li Xiang , Zheng Donghui
Published: April 2024

Ethnopharmacological relevance:

As a representative classical prescription, Sijunzi decoction has powerful therapeutic effects on spleen–stomach qi insufficiency. Ulcerative colitis (UC) is a chronic, diffuse, and non-specifically inflammatory disorder, the etiology of which still remains unclear. In the traditional Chinese medicine (TCM) perspective, splenic asthenia is the primary cause of UC. Based on this, Sijunzi decoction has been extensively used in TCM clinical practice to alleviate UC in recent years. However, the pharmacological mechanism of Sijunzi decoction in modern medicine is still not completely clear, which limits its clinical application.

Aim of the study:

The purpose of this study was to investigate the Sijunzi decoction’s curative effect on acute UC mice and probe into its potential pharmacological mechanism.

Materials and methods:

The UC mouse model was set up by freely ingesting a 3% dextran sulfate sodium (DSS) solution. The relieving role of Sijunzi decoction on UC in mice was analyzed by evaluating the changes in clinical parameters, colon morphology, histopathology, inflammatory factor content, intestinal epithelial barrier protein expression level, and gut microbiota balance state. Finally, multivariate statistical analysis was conducted to elucidate the relationship between inflammatory factors, intestinal epithelial barrier proteins, and gut microbiota.

Results:

First, the research findings revealed that Sijunzi decoction could visibly ease the clinical manifestation of UC, lower the DAI score, and attenuate colonic damage. Moreover, Sijunzi decoction could also significantly inhibit IL-6, IL-1β, and TNF-α while increasing occludin and ZO-1 expression levels. Subsequently, further studies showed that Sijunzi decoction could remodel gut microbiota homeostasis. Sijunzi decoction was beneficial in regulating the levels of Alistipes, Akkermansia, Lachnospiraceae_NK4A136_group, and other bacteria. Finally, multivariate statistical analysis demonstrated that key gut microbes were closely associated with inflammatory factors and intestinal epithelial barrier proteins.

Conclusion:

Sijunzi decoction can significantly prevent and treat UC. Its mechanism is strongly associated with the improvement of inflammation and intestinal epithelial barrier damage by regulating the gut microbiota.
Polyphenol supplementation boosts aerobic endurance in athletes: systematic review
Authors: Cao Gexin , Zuo Jing , Wu Baile , Wu Ying
Published: April 2024

In recent years, an increasing trend has been observed in the consumption of specific polyphenols, such as flavonoids and phenolic acids, derived from green tea, berries, and other similar sources. These compounds are believed to alleviate oxidative stress and inflammation resulting from exercise, potentially enhancing athletic performance. This systematic review critically examines the role of polyphenol supplementation in improving aerobic endurance among athletes and individuals with regular exercise habits. The review involved a thorough search of major literature databases, including PubMed, Web of Science, SCOPUS, SPORTDiscus, and Embase, covering re-search up to the year 2023. Out of 491 initially identified articles, 11 met the strict inclusion criteria for this review. These studies specifically focused on the incorporation of polyphenols or polyphenol-containing complexes in their experimental design, assessing their impact on aerobic endurance. The methodology adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the risk of bias was evaluated using the Cochrane bias risk assessment tool. While this review suggests that polyphenol supplementation might enhance certain aspects of aerobic endurance and promote fat oxidation, it is important to interpret these findings with caution, considering the limited number of studies available.

Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023453321.
Dissimilarity in radial growth and response to drought of Korshinsk peashrub (Caragana korshinskii Kom.) under different management practices in the western Loess Plateau
Authors: Che Cunwei , Zhang Mingjun , Yang Wanmin , Wang Shengjie , Zhang Yu , Liu Lingling
Published: April 2024

Quantitative assessment of tree responses to the local environment can help provide scientific guidance for planted forest management. However, research on the climate-growth relationship of Korshinsk peashrub (Caragana korshinskii Kom.) under different land preparation and post-management (irrigation) conditions is still insufficient. In this study, we collected 223 tree-ring samples from Korshinsk peashrubs using dendroecological methods and systematically quantified the relationships between shrub growth and climatic factors under different management practices in the western Loess Plateau of China. Our findings demonstrated that drought stress caused by scarce precipitation from April to August was the primary factor limiting the growth of Korshinsk peashrubs in the northern and southern mountains of Lanzhou. The “climwin” climate model results showed a weak correlation between natural Korshinsk peashrub growth and drought stress, whereas planted Korshinsk peashrub under rain-fed conditions in the southern mountain was significantly (p<0.05) limited by drought stress from April to August. Moreover, planted Korshinsk peashrub growth under irrigated conditions in the northern mountain was limited only by drought stress in January. Drought model explained 28.9%, 38.3%, and 9.80% of the radial growth variation in Xiguoyuan (XGY), Shuibaozhan (SBZ), and Zhichagou (ZCG) sites, respectively. Artificial supplementary irrigation alleviated the limitation of drought on planted forest growth, which may be implemented for Korshinsk peashrubs planted on sunny slopes, while planted Korshinsk peashrubs under natural rain-fed conditions can be planted on shady slopes through rainwater harvesting and conservation measures such as horizontal ditches and planting holes.
Focus of attention in musical learning and music performance: a systematic review and discussion of focus instructions and outcome measures
Authors: Hohagen Jesper , Immerz Anna
Published: April 2024

The topic of attentional focus (focus of attention, FOA) in musical learning and performance has recently received increasing interest, as the growing number of empirical studies inspired by the established FOA paradigm in sports by Wulf and colleagues in 1998. The current systematical review aims at collecting, abstracting, and categorizing relevant data to show which kinds of FOA instructions were applied in experimental designs and what kinds of dependent variables were used to measure the effects of FOA instruction on musical performance. The three main inclusion criteria in the selection process were experimental design, detailed descriptions of FOA instructions, and outcome measures (OMs). A systematic search was conducted with a complex search term in four scientific databases in March 2023. For presenting and synthesizing results, we used data collection and an inductive-deductive data categorization. Fifteen studies with a total sample size of 401 participants were included out of 387 records initially identified. We collected 53 different FOA instruction citations from the 15 studies and classified them into 9 FOA subcategories, of which the most applied were bodily focus (21%), sound focus (15%), and visual focus (14%). Selected studies used 63 OMs that were abstracted to 10 different OM categories with expert ratings (27%) and acoustical analysis (22%) as the most applied dependent variables. Data categorization and abstraction of additional study information show multiple combinations of FOA instructions, OMs, participants’ instruments and expertise, and musical tasks. Finally, studies show no consistent results of superiority of either external or internal or otherwise different FOA considering positive effects on musical performance. Limitations of the review lie in the small study sample, possible criticism of applied eligibility criteria, and subjectivity of data categorization. We propose a research agenda with a more exploratory approach that comprehensively and qualitatively examines the dimensions of musical goals to create a database that could provide a foundation for developing a music-specific FOA model.
Factors influencing death attitudes of medical students: a scoping review
Authors: Tong Jingjing , Liu Qian , Liu Ying , Li Juan , Zhang Qin , Shi Huashan
Published: April 2024

Aim

To summarize factors influencing death attitudes of medical students, help identify intervention targets, and design precision interventions for improving death attitudes of medical students.

Methods

Web of Science, PubMed, Embase, OVID, China National Knowledge Infrastructure, and Wanfang databases were searched. Retrieval time was from January 2012 to September 2023. Studies on factors influencing death attitudes of medical students were included.

Results

Thirty-five studies were included in the final review. A total of 28 factors influencing death attitudes of medical students were summarized and divided into three categories comprising personal factors, social factors, and psychological factors. More than 15 studies confirmed that gender, religion, and discussing death with families were factors that influenced medical students’ death attitudes.

Conclusion

Results indicate that there are many types of factors that influence death attitudes of medical students. It is necessary for universities to implement death education based individual characteristics and guide medical students to cultivate generally optimistic death attitudes and appropriate life values.
Comparing cytocompatibility of two fluoride-containing solutions and two resin-based restorative materials—a pilot study
Authors: Mulder Riaan , Noordien Naeemah , Potgieter Nicoline
Published: April 2024

Background

Cytocompatibility should always be considered, especially if the surface of treated carious lesions is close to soft tissue or is accidentally exposed to the oral soft tissue by the clinician.

Methods

The aim of the present study was to compare the cytocompatibility of two fluoride-containing liquids and two resin-containing restorative materials with buccal mucosa fibroblasts. The fluoride-containing materials were silver diamine fluoride and water-based silver fluoride.

Results

The statistical analysis was completed by comparing the positive control growth of the buccal mucosa fibroblasts to the growth of cells exposed to various materials. The one-way ANOVA with Tukey’s HSD result was completed. All the assessed materials compared to the control wells for both the 24 and 48 h time intervals indicated a significant cytocompatibility result, except for the test wells with Stela (SDI) at the 24 h time interval. There was no significant difference between the step 2 liquids and the two dental materials in cytocompatibility at the 24 h interval. All four materials indicated no significant differences between the cytocompatibility of any dental materials for 48 h.

Conclusion

The cytocompatibility assessment for Riva Star and Riva Star Aqua with the direct method in a full dispensing drop is not viable for step 1 of the fluoride-containing liquids. The use of Stela Light Cure is a suitable material that will be in contact with buccal mucosa as it showed potential for increased cytocompatibility compared to Riva Light Cure. Riva Star Aqua is more cytocompatible than Riva Star.
Pretransplant, Th17 dominant alloreactivity in highly sensitized kidney transplant candidates
Authors: Negi Sarita , Rutman Alissa K. , Saw Chee Loong , Paraskevas Steven , Tchervenkov Jean
Published: April 2024

Introduction

Sensitization to donor human leukocyte antigen (HLA) molecules prior to transplantation is a significant risk factor for delayed access to transplantation and to long-term outcomes. Memory T cells and their cytokines play a pivotal role in shaping immune responses, thereby increasing the risk of allograft rejection among highly sensitized patients. This study aims to elucidate the precise contribution of different CD4+memory T cell subsets to alloreactivity in highly sensitized (HS) kidney transplant recipients.

Methods and results

Stimulation of peripheral blood mononuclear cells (PBMC) with various polyclonal stimulating agents to assess non-specific immune responses revealed that HS patients exhibit elevated immune reactivity even before kidney transplantation, compared to non-sensitized (NS) patients. HS patients' PBMC displayed higher frequencies of CD4+T cells expressing IFNγ, IL4, IL6, IL17A, and TNFαand secreted relatively higher levels of IL17A and IL21 upon stimulation with PMA/ionomycin. Additionally, PBMC from HS patients stimulated with T cell stimulating agent phytohemagglutinin (PHA) exhibited elevated expression levels ofIFNγ,IL4and,IL21. On the other hand, stimulation with a combination of resiquimod (R848) and IL2 for the activation of memory B cells demonstrated higher expression ofIL17A,TNFα andIL21, as determined by quantitative real-time PCR. A mixed leukocyte reaction (MLR) assay, employing third-party donor antigen presenting cells (APCs), was implemented to evaluate the direct alloreactive response. HS patients demonstrated notably higher frequencies of CD4+T cells expressing IL4, IL6 and IL17A. Interestingly, APCs expressing recall HLA antigens triggered a stronger Th17 response compared to APCs lacking recall HLA antigens in sensitized patients. Furthermore, donor APCs induced higher activation of effector memory T cells in HS patients as compared to NS patients.

Conclusion

These results provide an assessment of pretransplant alloreactive T cell subsets in highly sensitized patients and emphasize the significance of Th17 cells in alloimmune responses. These findings hold promise for the development of treatment strategies tailored to sensitized kidney transplant recipients, with potential clinical implications.
Temporary meniscus extrusion is caused by cumulative stress from uphill and downhill tasks in healthy volunteers
Authors: Ishii Yosuke , Okamoto Saeko , Okinaka Riko , Hashizume Takato , Xu Chen , Zhu Kexin , Nakashima Yuko , Okada Kaoru , Takagi Kazuya , Adachi Nobuo , Takahashi Makoto
Published: April 2024

Purpose

Excessive mechanical stress accumulates and causes knee injury. Meniscal extrusion is a key factor in detecting the reaction to cumulative mechanical stress. The accumulation of stress strongly depends on environmental conditions such as flat ground or uphill/downhill, and accumulates in knee compartments; only a few studies have reported the effects of different environments on lateral and medial meniscus extrusion. This study aimed to investigate the effects of cumulative uphill/downhill stress on the meniscal extrusion in each compartment.

Methods

A total of 30 healthy volunteers with 30 affected knees were involved in this cohort study (mean age, 22.0 ± 1.1 years; men, n = 14). The participants were divided into flat-walking, uphill/downhill-walking, and uphill/downhill-jogging groups and their numbers of steps taken were recorded during the effort. Moreover, medial and lateral meniscal extrusions during walking were evaluated using ultrasound three times, before and after efforts (T1) and (T2), and one day after efforts (T3), respectively.

Results

In the flat-walking group, no significant differences were observed between the follow-up periods. Conversely, in the uphill/downhill-walking and jogging groups, the medial meniscus extrusion at T2 was significantly higher than that at T1. Conversely, the medial meniscus extrusion at T3 was significantly lower than that at T2. By contrast, the lateral meniscus did not show any difference between the follow-up periods in any group.

Conclusion

Temporary extrusion of the meniscus occurred after uphill/downhill tasks in healthy volunteers, and its reaction was observed only in the medial meniscus.
Regional Inequality and Associated Factors of Emergency Medicine Beds Distribution in China
Authors: Xiong Change , Xia Ying , Chen Huihui , Cheng Jing
Published: April 2024

Objective: The regional inequality of emergency medicine beds distribution has a great impact on population health as well as the accessibility of emergency services. This study aimed to explore the regional inequality of emergency medicine bed distribution and its influencing factors.

Methods: The Gini coefficient and health resource agglomeration were used to analyze the regional inequality of emergency medicine beds distribution by area from 2012 to 2021 in China. Grey correlation models were used to explore the factors influencing the regional inequality of emergency medicine beds distribution.

Results: From 2012 to 2021, Gini coefficients of emergency medicine beds distribution by geographic in China showed a worsening trend, rising from 0.6229 to 0.6636. The average HRAD index was 3.43 in the east and 0.44 in the west. Population structure factors have the greatest influence on the regional inequality of emergency medicine beds distribution.

Conclusion: Health resources allocation strategy only according to population size should be changed. In formulating policies for emergency medicine beds allocation should take into account population structure, financial structure of expenditure, the inequality of geographical distribution and so on.