bluuebunny/crossref_metadata_2025 huggingface dataset:
S11-2 Co-production of a physical activity referral scheme in the German health care system
Authors: Mino Eriselda , Klamroth Sarah , Weissenfels Anja , Naber Inga , Geidl Wolfgang , Gelius Peter , Abu-Omar Karim , Pfeifer Klaus
Published: September 2023

Purpose

Physical activity referral schemes (PARS) have the potential to promote physical activity (PA) among the mostly inactive primary care population with non-communicable diseases (NCD). Despite significant expansion throughout Europe, a national scheme has not yet been established in Germany. Thus, the ongoing research project BewegtVersorgt aims to develop, implement, and evaluate a PARS to promote PA for persons with NCD within the German healthcare system.

Methods

The PARS was developed using a co-production approach which integrated twelve organizations from different sectors within the healthcare system (health insurances, physicians, exercise professionals, patients’ representatives) and was guided by the research team. Initially, stakeholders’ ideas of a PARS were collected in individual interviews. These were followed by three co-production meetings where individual ideas and current evidence were combined, and different PARS models for the German setting were elaborated. Finally, all stakeholders agreed on one PARS for implementation as a regional model project.

Results

The co-produced PARS starts with the primary care physician, as the gatekeeper in the German healthcare system, who offers 10 min PA advice to the patients who would benefit from PA participation. Afterward, the patients are referred to an exercise professional through a referral form. The exercise professional delivers the remaining central components of the intervention - initial assessment, six 1-hour individual PA counseling sessions spread throughout 12 weeks, final assessment, a progress report to the general practitioner, and one follow-up visit at six months. The intervention uses a patient-centered approach and motivational interviewing. The end goal is an adaptation of an active lifestyle and transfer to local physical activity opportunities.

Conclusions

By using a co-production approach, the expertise of different stakeholders within the healthcare system as well as scientific findings could be integrated into the development process of the PARS. To which extent this participatory approach leads to greater acceptance of the new healthcare service among the implementing actors and positively influences their cooperation within the PARS will be evaluated during the implementation phase.

Support/Funding Source

The study is funded by the Federal Ministry of Health based on a resolution of the German ‘Bundestag’ by the federal government.
S14-5 Girls Active and Change4Life Sports Club - two effective programmes to increase physical activity in schools and colleges
Authors: Wright Chris , Taylor Wendy
Published: September 2023

Purpose

Girls Active aims to tackle declining participation in physical activity of girls aged 10 to 18 and its associated implications on health, wellbeing and education. Change4Life Sports Clubs are designed to address inactivity in 7 to 11 year olds and improve healthy lifestyle behaviours with exercise, food and hydration. Both projects aim to reduce physical inactivity of those children suffering the greatest challenges to achieving the recommended daily physical activity level of an average of 60 minutes of moderate to vigorous physical activity every day.

Project description

Both programmes were developed from evidence reviews and principles that work to engage, inspire and motivate targeted groups of children to be active. They were both developed by the children’s charity Youth Sport Trust, who have used sport and play to improve the lives of children and young people since 1995.

They were co-designed with children and implemented through a national network of 450 School Games Organisers. Youth Sports Trust’s ‘content, delivery, structure’ model was used. For Girls Active we used the Active Lives Children Data from Sport England and Change4Life Sports Clubs were aligned to the Department of Health’s National Child Measurement Programme data to target where the programmes were most needed and to ensure that the right groups of children and young people were included in the interventions.

Both programmes have been externally evaluated through academic partners using pre and post survey data, case studies and control elements and achieved high quality evidence scores. Both programmes have been scaled through a variety of funding streams including London 2012 Olympic Legacy, Sport England Lottery, Corporate Social Responsibility budgets and local public health funding. Girls Active has been adopted in Wales, Scotland and Northern Ireland.

Conclusions

We will share the evidence-based principles that have made these two approaches highly effective in addressing inactivity in primary school aged children and adolescent girls that can be applied in multiple contexts and will share resources and content that can be accessed following the session.
O.2.1-6 Effects of test modality and testing site on exercise-induced hypoalgesia in healthy human males: a protocol
Authors: Aron Vladimir , Deldicque Louise , Mouraux André
Published: September 2023

Background

A single session of physical exercise can acutely reduce experimental pain—a phenomenon known as exercise-induced hypoalgesia (EIH). There is inconsistency in the literature as to (1) whether EIH differentially impact the perception of different types of nociceptive stimuli (e.g., pressure versus thermal stimuli) and (2) whether exercise selectively modulates pain at exercising body parts, or also involves non-exercising body parts.

Purpose

We aim to characterize the effects of a single session of aerobic exercise on the sensitivity to stimuli activating skin versus muscle nociceptors, within or outside exercising body parts.

Methods

We will recruit 40 healthy male participants aged 18-30 years. First, we will familiarize them with the sensory assessments and conduct a maximal cycling test. Then, we will assess, in two sessions, the sensitivity to blunt pressure, mechanical pinprick, contact heat and cold, and auditory stimuli before and after a cycling exercise versus a control session. Sensory testing will be performed over the rectus femoris muscle of the dominant leg (local site) and over the flexor muscles of the non-dominant forearm (remote site). EIH will be quantified as the absolute and relative changes in sensitivity to the sensory stimuli before and after exercise.

Conclusions

We hypothesize that EIH will be greater (1) in the exercise than in the control session, (2) at the local site compared with the remote site if local changes in nociceptive sensitivity contribute to EIH, and (3) when blunt pressure stimuli are used if EIH involves specific changes in sensitivity of muscle nociceptors.
O.4.2-11 Effects of habit formation interventions on physical activity habit strength: meta-analysis and meta-regression
Authors: Ma Haoming , Wang Aoqi , Pei Runyuan , Piao Meihua
Published: September 2023

Background

Interventions aimed at promoting physical activity (PA) behavior through habit formation pathways are gaining popularity, as they differ from conventional interventions that rely on intention pathways. Past research has established a positive correlation between PA habits and behavior. However, the efficacy of current interventions designed to form PA habits and improve PA automaticity is not yet fully ascertained. Additionally, the intervention components that significantly impact the effectiveness of these interventions are yet to be determined.

Methods

We conducted a search of three databases (PubMed, Embase, and Cochrane Library) from January 2000 to December 2022, with a focus on interventions for developing PA habits. Two independent authors conducted paper selection, quality assessment, data extraction, and coding of behavior change techniques (BCTs). The effect size of interventions was calculated using standardized mean difference. Subgroup analyses were carried out based on follow-up duration, delivery method, sample characteristics, and theory. Furthermore, we employed meta-regression to investigate the association between BCTs and PA habits.

Results

Ten eligible studies with relatively high quality were included in the final data set. Characteristics of studies varied in intervention sample and delivery way. The habit formation interventions significantly increased PA habit (SMD=0.31, 95% CI 0.14 - 0.48, P<.001) compared to the control groups. Subgroup analysis demonstrated that the duration of follow-up≤12 weeks have a higher effect size on PA habit than the duration > 12 weeks. Meta-regression revealed that problem solving has a significant positive association with effectiveness improvement (β = 0.36, 95% CI 0.17–0.55), while social reward is linked with a reduction in effectiveness (β = -0.40, 95% CI -0.74–0.06).

Conclusions

Our findings reveal that habit formation interventions are effective in fostering PA habit. Future studies could leverage the insights form this study to optimize the intervention design and achieve better effectiveness.
O.4.3-9 Perceived COVID-19 impact and its relationship with Physical Activity in youths in Luxembourg: Health Behaviour in School-aged Children 2022 survey
Authors: Mendes Felipe Goedert , Ferreira Joana Lopes , Catunda Carolina
Published: September 2023

Purpose

The prevention measures undertaken due to the COVID-19 pandemic, such as lockdown and social distancing may have caused changes in the population’s lifestyle, including physical activity (PA). The current study aimed to investigate the PA level according to the perceived COVID-19 impact in youth in Luxembourg.

Methods

This representative cross-sectional study was based on the Health Behaviour in School-aged Children (HBSC) Luxembourg 2022 survey. The population includes 8018 participants aged 11 to 18 years old. The PA was measured on how many days per week they practice 60 or more minutes of moderate-vigorous (MVPA) and vigorous PA (VPA). The perceived COVID-19 impact on PA was measured by the question “What impact did the Covid-19 measures have on your PA?”, with 5 answers categories ranging from very negative to very positive. A chi-square test was performed to observe the association between the perceived COVID-19 impact on PA and gender. In addition, a linear regression was performed to analyse the relation between MVPA and VPA and the perceived COVID-19 impact, adjusted by age, splited by gender.

Results

An association was found between gender and the perceived COVID-19 impact on PA. 28.2% of boys perceived a very positive impacted of COVID-19 on PA, compared to 15.5% of girls. There was a relationship between MVPA, and the perceived COVID-19 impact on PA, in both genders. Participants who perceived a positive impact of the COVID-19 on PA practiced MVPA and VPA more frequently than the others, for both boys (β = 0.491, p < 0.001 and β = 0.491, p < 0.001, respectively) and girls (β = 0.543, p < 0.001 and β = 0.733, p < 0.001, respectively).

Conclusions

Findings suggest a rather positive impact of the COVID-19 on PA, especially for boys. In addition, those who perceived a positive impact practiced significantly more days of MVPA and VPA, in both gender. This study highlights adolescent’s perception of COVID-19 impacts on their PA and draw attention to the positive impact perceived and its relation to an increased PA practice. Future studies should further investigate the reasons behind the perception of a positive impact, in order to mimic the contextual factors favouring the increased practice of PA.
Effective policies to promote sugar reduction in soft drinks: lessons from a comparison of six European countries
Authors: Allais Olivier , Enderli Géraldine , Sassi Franco , Soler Louis-Georges
Published: September 2023

Background

Many countries have sought to incentivise soft drinks manufacturers to reduce sugar in their products as part of efforts to address a growing prevalence of obesity. Are their policies effective?

Methods

Using a difference-in-differences design, we compared trends in the sugar content of 10 695 new sugar-sweetened beverages (SSB) launched between 2010 and 2019 in six European markets, including the UK and France (taxes designed to incentivise reformulation), the Netherlands (policy based on voluntary agreements to reduce sugar), Germany, Italy and Spain (no national policies).

Results

The announcement in 2016 and adoption in 2018 of the UK tax led to yearly reductions in average sugar content of 17% (95% CI: 15–19%) to 31% (13–48%) between 2016 and 2019, compared to 2015, while the 2018 French tax produced a 6% (95% CI: 5–7%) sugar reduction only in 2018, compared to 2017, shortly after it was redesigned to provide a stronger incentive for reformulation. Voluntary agreements implemented in the Netherlands in 2014 led to an 8% (95% CI: 4–13%) sugar reduction only in 2015, compared to 2013.

Conclusion

The analysis supports the conclusions that sugar reductions in new SSBs have been greater in countries that have adopted specific policies to encourage them; a sugar-based tax design encourages more sugar reductions than a volume-based tax design; the tax rate and the amount of the tax reduction from switching to the next lower tier in a sugar-based tax design may be critical to incentivize reformulation.
Combination of geometric and gravimetric data sets for the estimation of high-resolution mass balances of the Greenland ice sheet
Authors: Graf M , Pail R
Published: September 2023

In this study, we develop a model that allows to combine gravimetric and geometric data. By the combination, we improve the spatial resolution of the resulting mass balance estimate compared to a purely gravimetric one. The equivalent ice or firn density of the changing ice volume is estimated within a mathematical inversion model, which includes geometric information about the volumetric change of the ice sheet and the resulting gravity change. This gravity change is computed from monthly GRACE gravity fields. They have a limited spatial resolution of a few 100 km, but allow direct conclusions about the true mass changes over Greenland. The ice-volume changes are described by a product by the Climate Change Initiative of European Space Agency, which is based on altimetry data. They have a very fine spatial resolution (down to a few km), but are not directly sensitive to mass changes. By combining both data sets in a common mathematical model, the advantages of both data types (direct sensitivity to mass versus high spatial resolution) are made use of. In this way, we improve the spatial resolution of mass balance estimates over Greenland. This leads to a map of mass trends, which has the same spatial resolution as the input map of geometric changes, but which is consistent with the input gravity fields. It will enable improving the localization of mass change signals of ice sheets and glaciers, which are usually rather small-scale. We compare our estimates to the results of complementary studies regarding the total mass loss of the Greenland ice sheet and its surrounding land surface. Our study leads to a value of $-213\pm 37\, \text{Gt}\,\text{a}^{-1}$ in the time span from 2011 to 2015. We also discuss the problem of separating the mass contribution of the Greenland ice sheet itself and its surrounding region.
Repeat Sampling of Female Passerines During Reproduction Reveals Surprising Higher Plasma Oxidative Damage During Resting Compared to Active State
Authors: Coughlan Kyle , Sadowska Edyta T , Bauchinger Ulf
Published: September 2023

Synopsis

Traditional models of oxidative stress predict accumulation of damage caused by reactive oxygen species (ROS) production as highly correlated with aerobic metabolism, a prediction under increasing scrutiny. Here, we repeat sampled female great tits (Parus major) at two opposite levels of energy use during the period of maximum food provisioning to nestlings, once at rest and once during activity. Our results were in contrast to the above prediction, namely significantly higher levels of oxidative damage during rest opposed to active phase. This discrepancy could not be explained neither using levels of “first line” antioxidant enzymes activity measured from erythrocytes, nor from total nonenzymatic antioxidant capacity measured from plasma, as no differences were found between states. Significantly higher levels of uric acid, a potent antioxidant, were seen in the plasma during the active phase than in rest phase, which may explain the lower levels of oxidative damage despite high levels of physical activity. Our results challenge the hypothesis that oxidative stress is elevated during times with high energy use and call for more profound understanding of potential drivers of the modulation of oxidative stress such as metabolic state of the animal, and thus also the time of sampling in general.
On Abel’s Problem and Gauss Congruences
Authors: Delaygue É , Rivoal T
Published: September 2023

A classical problem due to Abel is to determine if a differential equation $y^{\prime}=\eta y$ admits a non-trivial solution $y$ algebraic over $\mathbb C(x)$ when $\eta $ is a given algebraic function over $\mathbb C(x)$. Risch designed an algorithm that, given $\eta $, determines whether there exists an algebraic solution or not. In this paper, we adopt a different point of view when $\eta $ admits a Puiseux expansion with rational coefficients at some point in $\mathbb C\cup \{\infty \}$, which can be assumed to be 0 without loss of generality. We prove the following arithmetic characterization: there exists a non-trivial algebraic solution of $y^{\prime}=\eta y$ if and only if the coefficients of the Puiseux expansion of $x\eta (x)$ at $0$ satisfy Gauss congruences for almost all prime numbers. We then apply our criterion to hypergeometric series: we completely determine the equations $y^{\prime}=\eta y$ with an algebraic solution when $x\eta (x)$ is an algebraic hypergeometric series with rational parameters, and this enables us to prove a prediction Golyshev made using the theory of motives. We also present two other applications, namely to diagonals of rational fractions and to directed two-dimensional walks.
Relevant Generality of Antitrust Economics: Competitive Effects as Adjudicative and Legislative Facts
Authors: Broulík Jan
Published: September 2023

Antitrust enforcement proceedings routinely rely on information provided by positive economics. Recognizing that this information may help the court to decide what happened in the case at bar as well as what substantive rule to apply to the case, this article examines how general the information needs to be to bear relevance to each of these decision-making tasks. The examination is conducted in the context of US law, relies on the conventional distinction between adjudicative and legislative facts, and focuses on competitive effects as the paramount type of antitrust facts. Economic inquiries into the competitive effects of the conduct under scrutiny are then shown to be relevant if they take sufficient account of the specifics of the case. This requirement will rarely be satisfied by inquiries based on generic models. In contrast, when deciding on the content of the applicable antirust rule, the court needs comprehensive information about the competitive effects of the entire conduct class. Economic analyses into the effects of specific conduct will hence be hardly relevant.
Fundamentals of HIV Medicine 2023
Authors:   The American Academy of HIV Medicine
Published: September 2023

Chapter 2: This chapter discusses the global prevalence as well as the geographic distribution of HIV-1 and HIV-2 infections and updates on recent shared global initiatives. The demographic trends in HIV in the United States, especially regarding gender, sexuality, race, ethnicity, age, injection-drug use, socioeconomic status, and recent initiatives are reviewed. Special attention is paid to HIV among communities of color, as well as women, children, and adolescences. The role of HIV in men who have sex with men and the transgender community is reviewed in detail. Chapter 8: HIV Testing and Counselling lists and describes the various types of HIV testing available. The chapter also presents an overview of HIV counselling. HIV testing terminology and algorithms are presented to the reader along with descriptive figures. Laboratory markers for HIV are reviewed. The chapter describes who should be tested, as well as pre and post-test counselling elements. A section of the chapter is dedicated to special populations and environments (blood supply screening, prenatal screening, testing settings) Strategies to improve uptake of HIV testing are discussed.
Mechanisms of HIV Transmission
Authors: Aitcheson Nancy , Nambiar Puja H.
Published: September 2023

With over 25 years of experience demonstrating that antiretroviral therapy is highly effective in reducing the transmission of HIV, there is now clear evidence that individuals living with HIV with an undetectable viral load cannot transmit HIV sexually. Clinical trial data demonstrate that treatment of HIV is also prevention. This chapter outlines the various ways of HIV transmission including sexual transmission, transmission in the healthcare setting, transmission through the use of injection drugs, and perinatal. The significance of viral load quantity and its relationship to transmission risk is discussed as well as the impact of co-occurring sexually transmitted diseases in HIV transmission.
Initial Evaluation of the Person with HIV
Authors: Morales Esteban A. DelPilar , Skiest Daniel J.
Published: September 2023

The chapter describes what is essential in the HIV-oriented medical history as well as the HIV-oriented physical examination. Detailed descriptions of what is needed for the medical history, the physical examination, the initial HIV laboratory evaluation, and signs and symptoms of acute retroviral illness are presented to the reader via tables. This chapter provides additional insight into gender identity and cultural challenges that can affect the management of some persons with HIV. It outlines the importance of patient-provider relationships and addresses issues such as cultural competency and language. The role of telehealth in managing persons with HIV is briefly touched on.
Special Populations
Authors: Silva Catherine , Arrington-Sanders Renata , Goldstein Zil G. , Deutsch Madeline B. , Asupoto Olabimpe , Wurcel Alysse G. , Imbert Elizabeth , Hickey Matthew D. , Davids Abby , Carvalho Ashley , Garcia Deliana , Seda Claire M. Hutkins , Madaras Laszlo
Published: September 2023

The epidemiologic focus of HIV in the United States has been in men who have sex with men, particularly in younger men of color. This chapter discusses several other populations experiencing disproportionate access to healthcare, including, adolescents, transgender persons, homeless or displaced individuals, incarcerated individuals, patients in rural settings, immigrants and migrant workers. Learners will review the impact of stigma on healthcare-seeking behavior, treatment adherence, and safe practices.
Complementary and Alternative Medicine/Integrative Medicine Approaches
Authors: Desai Yash , Shere-Wolfe Kalpana D.
Published: September 2023

A comprehensive explanation of complementary and alternative medicine (CAM) and integrative medicine is provided at the beginning of this chapter. The use of CAM by people with HIV is discussed as well as physicians’ attitudes toward CAM. The chapter covers the benefits of natural health products for use in people with HIV and provides extensive examples of these products. Mind–body approaches to treatment are reviewed in detail in addition to traditional medicine and manual therapies. This edition contains updated information on the effects of micronutrient supplementation on CD4+ T-cell counts and HIV disease progression as well fish oil supplementation. In addition, herb–drug interactions are reviewed, with new data presented on interactions with newer antiretroviral medications.
HIV-Associated Lipodystrophy and Lipoatrophy
Authors: Sekhar Rajagopal V.
Published: September 2023

The incidence of new-onset lipodystrophy has declined in recent years. HIV is associated with abnormal fat distribution, which is termed lipodystrophy. HIV lipodystrophy can manifest as fat loss (lipoatrophy), fat gain (lipohypertrophy), or a mixed pattern. Therapeutic options are limited, and treatment is challenging. HIV lipodystrophy is associated with increased risk of developing cardiovascular disease, fatty liver disease, and renal disease. HIV lipodystrophy is associated with a negative body image. This chapter discusses abnormal fat distribution This chapter discusses abnormal fat distribution (lipodystrophy) associated with HIV and antiretroviral therapy by describing what is currently know about HIV-associated lipodystrophy, the current clinical implications of lipodystrophy in persons with HIV and the therapeutic interventions to treat and improve the health status of person with HIV and lipodystrophy. The learner will also understand the different manifestations of lipodystrophy including fat loss (lipoatrophy), fat gain (lipohypertrophy), or mix patterns and the increased risk of developing dyslipidemia, insulin resistance, diabetes mellitus, cardiovascular disease, fatty liver disease, renal disease, and metabolic syndrome, and associated treatments.
Sexually Transmitted Diseases
Authors: Vigil Karen J.
Published: September 2023

Sexually transmitted infections (STIs) are common in people living with HIV (PWH). Education and counseling on changes in sexual behaviors of patients with STIs and their sexual partners, identification of asymptomatically infection, and effective diagnosis and treatment are the cornerstones for prevention. This chapter demonstrates the established and evolving science regarding the diagnosis and treatment of most prevalent STIs in PWH, including syphilis, gonorrhea, chlamydia, human papilloma virus, and genital ulcers. The learner will be able to identify the clinical presentation of each sexually transmitted disease, discuss available diagnostic tests and tools, and describe the recommended treatments in order to decrease the spread of sexually transmitted diseases.
Renal Complications
Authors: Reese Patricia Carr , Farooq Umar
Published: September 2023

Persons living with HIV (PWH) continue to have an increased risk of developing chronic kidney disease. Because of antiretroviral therapy (ART) availability, the most common etiologies of kidney disease have changed over the course of the epidemic from HIV-associated nephropathy to renal complications from noninfectious comorbidities such as diabetes, hypertension, hepatitis infection, tobacco use, and aging in general. Consistent evidence demonstrates preservation of renal function with ART in PWH. PWH are eligible for both renal dialysis and renal transplant. This chapter discusses the continued high prevalence of renal disease in PWH and the broad pathologic spectrum of renal disease including medication-induced renal injury. It also allows the learner to understand the importance of screening and monitoring people with HIV for chronic kidney disease along with the indications for nephrology referral and renal biopsy, potential targets of interventions for HIV-associated renal diseases, and treatment options for PWH who have end-stage renal disease, including dialysis and solid organ transplant.
Non-LTE Monte Carlo radiative transfer – III. The thermal properties of tilted and warped Be star discs
Authors: Suffak M W , Jones C E , Carciofi A C , de Amorim T H
Published: September 2023

We use the three-dimensional Monte Carlo radiative transfer code hdust to model Be stars where the disc is tilted from the equatorial plane of the star. We compute 128 models across four spectral types, B0, B2, B5, and B8, tilting the disc by 0, 10○, 20○, and 40○, respectively, while varying disc density according to spectral type. We also compute every model for an average and high stellar rotation rate. We first discuss non-tilted disc temperatures and show its nonlinear dependence on stellar and disc parameters. We find that tilting the disc minimally affects the density-weighted average disc temperature, but tilting does create a temperature asymmetry in disc cross-sections, which is more pronounced for a faster rotation rate. We also investigate the effect tilting has on V-band magnitude, polarization, and the H$\rm \alpha$ line. Tilting the disc does affect these observables, but the changes are entirely dependent on the position of the observer relative to the direction of tilt. We find the observables that distinguish tilting from a change in density or geometry are the H$\rm \alpha$ line shapes, where it can transition between single-peaked and double-peaked, and the polarization position angle, whose value is dependent on the projected major elongation axis of the disc on the sky. We also present one early- and one late-type model with warped discs. We find their temperature structure varies a small amount from the uniformly tilted models, and the different observables correspond to different tilt angles, consistent with their expected volume of origin within the disc.
Acute effects of energy drink consumption on cardiovascular parameters in healthy adults: a systematic review and meta-analysis of randomized clinical trials
Authors: Gualberto Pedro I B , Benvindo Vinícius V , Waclawovsky Gustavo , Deresz Luís F
Published: September 2023

Context

Energy drinks (EDs) are beverages that contain ingredients that may pose a risk to consumers’ cardiovascular health. But current evidence is conflicting and warrants further investigation.

Objective

A systematic review and meta-analysis was conducted on studies that examined the acute effects of ED consumption on systolic blood pressure (SBP), diastolic blood pressure (DBP), resting heart rate, cardiac output (CO), endothelial function, and QT/QTc interval in healthy adults.

Data Sources

The databases PubMed, EMBASE, Cochrane, LILACS, Web of Science, SportDiscus, and the gray literature were searched to identify randomized controlled trials (RCTs).

Data Extraction

Two independent evaluators screened 2014 studies and extracted relevant data from those selected for the analysis. A risk of bias assessment was also performed with the RoB 2 tool and a strength of evidence assessment was performed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Data Analysis

A total of 17 RCTs were included in the meta-analysis. With regard to risk of bias, 11 studies were rated as having “some concerns” and 6 as “high risk of bias.” The consumption of EDs increased SBP, DBP, and CO in different time frames. More pronounced effects were seen on SBP at 60-80 minutes (4.71 mmHg; 95% CI: 2.97–6.45; GRADE: moderate), DBP at 120 minutes (4.51 mmHg; 95% CI: 2.60–6.42; GRADE: low), and CO at 30-40 minutes after consumption (0.43 L; 95% CI: 0.08–0.77; GRADE: very low). The effects of ED consumption on resting heart rate and QT/QTc interval were not significant (P ≤ 0.05). The assessment of endothelial function effects was not performed due to the absence of any RCTs meeting the inclusion criteria.

Conclusions

Acute consumption of EDs increases SBP, DBP, and CO in healthy adults. However, no alterations were observed in other cardiovascular parameters. The results should be interpreted with caution due to the limited number of studies included in the analysis.

Systematic Review Registration

PROSPERO registration no. CRD42022295335.
Nutritional interventions in treating menopause-related sleep disturbances: a systematic review
Authors: Polasek Dominik , Santhi Nayantara , Alfonso-Miller Pamela , Walshe Ian H , Haskell-Ramsay Crystal F , Elder Greg J
Published: September 2023

Context

Sleep disturbances are a core symptom of menopause, which refers to the permanent cessation of menstrual periods. Nutritional interventions may alleviate menopause-related sleep disturbances, as studies have shown that certain interventions (eg, tart cherry juice, or tryptophan-rich foods) can improve relevant aspects of sleep.

Objective

The aim of this systematic review was to examine the effect of nutritional interventions for menopause-related sleep disturbances, in order to inform the subsequent development of specific interventional trials and assess their potential as a treatment for menopause-related sleep disturbances.

Data Sources

Published studies in English were located by searching PubMed and PsycArticles databases (until September 15, 2022).

Data Extraction

Following full-text review, a final total of 59 articles were included. The search protocol was performed in accordance with PRISMA guidelines.

Data Analysis

A total of 37 studies reported that a nutritional intervention improved some aspect of sleep, and 22 studies observed no benefit. Most (n = 24) studies recruited postmenopausal women, 18 recruited menopausal women, 3 recruited perimenopausal women, and 14 recruited women from multiple groups. The majority of the studies were of low methodological quality. Due to the heterogeneity of the studies, a narrative synthesis without meta-analysis is reported.

Conclusion

Despite the large heterogeneity in the studies and choice of intervention, the majority of the identified studies reported that a nutritional intervention did benefit sleep, and that it is mainly subjective sleep that is improved. More high-quality, adequately powered, randomized controlled trials of the identified nutritional interventions are necessary.

Systematic Review Registration

PROSPERO registration no. CRD42021262367.
Transition luminosities of Galactic black hole transients with Swift/XRT and NICER/XTI observations
Authors: Wang Sili , Kawai Nobuyuki , Shidatsu Megumi , Matsuoka Yoshiki
Published: September 2023

The X-ray spectral state transitions of Galactic black hole transients (GBHTs) are often linked to the changes in the mass accretion rate. A narrow distribution of transition luminosity in terms of the Eddington ratio has been found in previous studies of GBHTs based on RXTE data (Maccarone, 2003, A&A, 409, 697; Vahdat Motlagh et al., 2019, MNRAS, 485, 2744) and this Eddington ratio at the transition is often used in recent studies with instruments such as Swift/XRT and NICER/XTI, covering soft energies below 1 to 10 keV. However, the X-ray states characterized by spectral parameters may have different definitions depending on the energy ranges adopted in the spectral analysis, leaving the question of whether the distribution of transition luminosity obtained with RXTE remains the same when we use the instruments covering softer energy bands. In this work, we investigated the X-ray state evolutions and the variations of luminosities of eight outbursts of seven GBHTs. We found that the bolometric luminosity of the power-law component was tightly constrained to $\sim\! 1.3\%$ Eddington luminosity at index transition when the photon index starts to decrease towards the hard state, which is consistent with the previous RXTE results (Vahdat Motlagh et al. 2019, MNRAS, 485, 2744; Kalemci et al. 2013, ApJ, 779, 95). Moreover, the tightest clustering was found to be the power-law luminosity right after the start of disk recession, with a mean logarithmic Eddington ratio of −1.84 ± 0.28. In addition, our results suggest that the disk recession starts after the bolometric disk luminosity drops below 1% Eddington luminosity.
Stomatal opening efficiency is controlled by cell wall organization in Arabidopsis thaliana
Authors: Keynia Sedighe , Jaafar Leila , Zhou You , Anderson Charles T , Turner Joseph A
Published: September 2023

Stomatal function in plants is regulated by the nanoscale architecture of the cell wall and turgor pressure, which together control stomatal pore size to facilitate gas exchange and photosynthesis. The mechanical properties of the cell wall and cell geometry are critical determinants of stomatal dynamics. However, the specific biomechanical functions of wall constituents, for example, cellulose and pectins, and their impact on the work required to open or close the stomatal pore are unclear. Here, we use nanoindentation in normal and lateral directions, computational modeling, and microscopic imaging of cells from the model plant Arabidopsis thaliana to investigate the precise influences of wall architecture and turgor pressure on stomatal biomechanics. This approach allows us to quantify and compare the unique anisotropic properties of guard cells with normal composition, lower cellulose content, or alterations in pectin molecular weight. Using these data to calculate the work required to open the stomata reveals that the wild type, with a circumferential-to-longitudinal modulus ratio of 3:1, is the most energy-efficient of those studied. In addition, the tested genotypes displayed similar changes in their pore size despite large differences in wall thickness and biomechanical properties. These findings imply that homeostasis in stomatal function is maintained in the face of varying wall compositions and biomechanics by tuning wall thickness.
Extra-osseous manifestations in chronic recurrent multifocal osteomyelitis: a retrospective study
Authors: Robert Marie , Giolito Anna , Reumaux Heloise , Rossi-Semerano Linda , Guillemin Claire , Biarrotte Louis , Leguevaques Damia , Belot Alexandre , Duquesne Agnès , Frachette Cécile , Laurent Audrey , Desjonquères Marine , Larbre Jean-Paul , Galeotti Caroline , Koné-Paut Isabelle , Dusser Perrine
Published: September 2023

Objectives

Extra-osseous (EO) manifestations are poorly characterized in chronic recurrent multifocal osteomyelitis (CRMO). This study aimed to further define the frequency, characteristics and treatment of EO events in CRMO and whether different phenotypes can be distinguished and benefit from special management.

Methods

This multicentre retrospective study included CRMO patients followed in several paediatric rheumatology departments in France between 2015 and 2022. EO manifestations were defined as skin lesions, gastrointestinal manifestations, arthritis, enthesitis, sacroiliitis, uveitis, vasculitis and fever. At the last visit, the physician defined CRMO as active in the presence of clinical manifestations including both osseous and EO symptoms.

Results

We included 133 patients; 87 (65.4%) were girls and the median age at first symptoms was 9.0 years (interquartile range 7.0–10.0). EO manifestations were described in 90 (67.7%) patients, with a predominance of skin lesions [n = 51/90 (56.7%)], followed by sacroiliitis [n = 38/90 (42.2%)], enthesitis [n = 21/90 (23.3%)], arthritis [n = 14/90 (15.6%)] and gastrointestinal manifestations [n = 6/90 (6.7%)]. The use of non-steroidal anti-inflammatory drugs and bisphosphonates did not differ by the presence or not of EO manifestations. Biologics were taken more frequently by patients with than without EO manifestations (P < 0.001); TNF inhibitors were used in 33 (36.7%) EO-positive patients. Under this treatment, 18 (54.5%) patients achieved complete remission of osseous and EO manifestations. At the last visit, more EO+ than EO− patients were on treatment (P = 0.009), with active disease in 58 (64.4%) patients.

Conclusion

The analysis of EO manifestations in CRMO delineates two groups of patients in terms of severity and treatments used. Our study opens up new pathophysiological leads that may underlie the wide range of CRMO phenotypes.
Pathology-based radiation dose in computed tomography: investigation of the effect of lung lesions on water-equivalent diameter, CTDIVol and SSDE in COVID-19 patients
Authors: Mohammadbeigi Ahmad , Shouraki Jalal Kargar , Ebrahiminik Hojat , Nouri Majid , Bagheri Hamed , Moradi Hamid , Azizi Ahmad , Fadaee Narges , Soltanzadeh Taher , Moghimi Yousef
Published: September 2023

Lung lesions can increase the CT number and affect the water-equivalent diameter (Dw), Dw-based conversion factor (CFw), and Dw-based size-specific dose estimate (SSDEw). We evaluated the effect of COVID-19 lesions and total severity score (TSS) on radiation dose considering the effect of automatic tube current modulation (ATCM) and fixed tube current (FTC). A total of 186 chest CT scans were categorised into five TSS groups, including healthy, minimal, mild, moderate and severe. The effective diameter (Deff), Dw, CFw, Deff-based conversion factor (CFeff), volume computed tomography dose index (CTDIVol), pathological dose impact factor (PDIF) 1 and SSDEw were calculated. TSS was correlated with Dw (r = 0.29, p-value = 0.001), CTDIVol (ATCM) (r = 0.23, p = 0.001) and PDIF (r = − 0.51, p-value = 0.001). $\overline{{\mathrm{SSDE}}_{\mathrm{w}}}$ (FTC) was significantly different among all groups. $\overline{{\mathrm{SSDE}}_{\mathrm{w}}}$ (ATCM) was greater for moderate (13%) and mild (14%) groups. Increasing TSS increase the Dw and causes a decrease in CFw and $\overline{{\mathrm{SSDE}}_{\mathrm{w}}}$ (FTC), and can increase $\overline{{\mathrm{SSDE}}_{\mathrm{w}}}$ (ATCM) in some Dw ranges.
Prevalence of central sleep apnea in people with tetraplegic spinal cord injury: a retrospective analysis of research and clinical data
Authors: Graco Marnie , Ruehland Warren R , Schembri Rachel , Churchward Thomas J , Saravanan Krisha , Sheers Nicole L , Berlowitz David J
Published: September 2023

Study Objectives

Over 80% of people with tetraplegia have sleep-disordered breathing (SDB), but whether this is predominantly obstructive or central is unclear. This study aimed to estimate the prevalence of central sleep apnea (CSA) in tetraplegia and the contributions of central, obstructive, and hypopnea respiratory events to SDB summary indices in tetraplegia.

Methods

Research and clinical data from 606 individuals with tetraplegia and full overnight polysomnography were collated. The proportions of different respiratory event types were calculated; overall and for mild, moderate, and severe disease. The prevalence of Predominant CSA (Central Apnea Index [CAI] ≥ 5 and more central than obstructive apneas) and Any CSA (CAI ≥ 5) was estimated. Prevalence of sleep-related hypoventilation (SRH) was estimated in a clinical sub-cohort.

Results

Respiratory events were primarily hypopneas (71%), followed by obstructive (23%), central (4%), and mixed apneas (2%). As severity increased, the relative contribution of hypopneas and central apneas decreased, while that of obstructive apneas increased. The prevalence of Predominant CSA and Any CSA were 4.3% (26/606) and 8.4% (51/606) respectively. Being male, on opiates and having a high tetraplegic spinal cord injury were associated with CSA. SRH was identified in 26% (26/113) of the clinical sub-cohort.

Conclusions

This is the largest study to characterize SDB in tetraplegia. It provides strong evidence that obstructive sleep apnea is the predominant SDB type; 9–18 times more prevalent than CSA. The prevalence of CSA was estimated to be 4%–8%, significantly lower than previously reported.
Glymphatic system dysfunction in restless legs syndrome: evidenced by diffusion tensor imaging along the perivascular space
Authors: Park Kang Min , Kim Keun Tae , Lee Dong Ah , Motamedi Gholam K , Cho Yong Won
Published: September 2023

Study Objectives

There is growing evidence pointing at glymphatic system dysfunction in diseases with circadian disruption, such as sleep disorders. Lower diffusivity in the direction of perivascular space has been shown in several neurological and sleep-related disorders; however, its role in restless legs syndrome (RLS) is unclear. We hypothesized that similarly, in RLS the diffusivity in glymphatic system is decreased. Here, we aimed to evaluate glymphatic system functionality in patients with RLS, compare it to healthy controls, and analyze the correlation between its function and clinical characteristics.

Methods

Sixty-nine patients with primary RLS and 51 healthy controls were recruited at a tertiary hospital. All participants underwent diffusion tensor imaging (DTI) and magnetic resonance imaging (MRI) using a 3T MRI scanner, and the DTI along the perivascular space (DTI-ALPS) index was calculated using DTI data. We compared the DTI-ALPS index between the patients with RLS and healthy controls. We also conducted the correlation analysis between the DTI-ALPS index and clinical characteristics, including age, age of onset, symptom duration, and RLS severity.

Results

DTI-ALPS index differed significantly between the patients with RLS and healthy controls; the DTI-ALPS index in the patients with RLS was lower than that in the healthy controls (1.48 vs. 0.60, p = 0.008). There was no significant correlation between the DTI-ALPS index and clinical characteristics.

Conclusion

A significantly lower DTI-ALPS index in patients with RLS suggests that the glymphatic system function is impaired in patients with RLS.
Preconditioning Concepts for the Therapeutic Use of Extracellular Vesicles Against Stroke
Authors: Haupt Matteo , Gerner Stefan T , Huttner Hagen B , Doeppner Thorsten R
Published: September 2023

Various preclinical stroke models have demonstrated the neuroprotective effects of extracellular vesicles (EVs) obtained from several types of cells, including neurons, astrocytes, microglia, neuronal progenitor cells, bone marrow stem cells, and mesenchymal stem cells. EVs interfere with key mechanisms in stroke pathophysiology such as cell death, neuroinflammation, autophagy, and angiogenesis. The mode of action and efficacy depend on the specific EV content, including miRNAs, proteins, and lipids, which can be modified through (I) bioengineering methods, (II) choice of source cells, and (III) modification of the source cell environment. Indeed, modifying the environment by preconditioning the EV-secreting cells with oxygen-glucose deprivation or medium modification revealed superior neuroprotective effects in stroke models. Although the concept of preconditioned EVs is relatively novel, it holds promise for the future treatment of ischemic stroke. Here, we give a brief overview about the main mechanisms of EV-induced neuroprotection and discuss the current status of preconditioning concepts for EV-treatment of ischemic stroke.
Neurotrophic keratitis: inflammatory pathogenesis and novel therapies
Authors: Wajnsztajn Denise , Faraj Lana A. , Sanchez-Tabernero Sara , Solomon Abraham
Published: September 2023

Purpose of review

Neurotrophic keratitis is a rare degenerative disease characterized by decrease or absence of corneal sensation. Neurotrophic keratitis varies from mild forms with mild epitheliopathy to severe manifestations such as corneal ulceration, melting and perforation that can lead to irreversible visual loss. The cause of neurotrophic keratitis comprises a long list of diseases, medications, congenital or genetic conditions as well as trauma. The mechanism of neurotrophic keratitis is complex and multifactorial and its understanding is crucial to better address the treatment strategies. We aimed to review neurotrophic keratitis pathology, mechanisms and management.

Recent findings

Corneal nerves are critical for the homeostasis of a healthy ocular surface. The lack of nerve-derived neuromediators and corneal-released neuropeptides, neuro-trophins and neurotrophic factors in neurotrophic keratitis leads to a decrease in trophic supply to corneal cells in addition to a decrease in afferent signaling to the brain. This results in pathological tear secretion, decreased blinking rate, corneal healing along with ocular surface and corneal inflammation. Lately, nerve growth factor in special gained emphasis as a treatment strategy targeting the disease mechanism rather than its manifestations. Other therapies, including surgical interventions, are in the pipeline of neurotrophic keratitis management. However, there are still no proper therapeutic guidelines and neurotrophic keratitis treatment remains challenging.

Neurotrophic keratitis may have a devastating outcome and treatment is still challenging. Understanding the disease pathology may assist in the development of new treatment strategies. Prompt disease recognition and immediate intervention are key factors to promote corneal healing and avoid further deterioration.