Associations of Tai Chi With Depression and Anxiety Among Older Adults: Nationwide Study Findings From a Network Perspective

Within the global population, depression and anxiety are common among older adults. Tai Chi is believed to have a positive impact on these disturbances. This study examined the network structures of depression and anxiety among older Tai Chi practitioners vs non-practitioners. Propensity score matching (PSM) was used to construct a non-practitioner group based on Chinese Longitudinal Healthy Longevity Survey (CLHLS) data. 346 Tai Chi practitioners and 1019 non-practitioners were included. The prevalence and severity rates of depression were significantly lower among Tai Chi practitioners compared to non-practitioners though there was no group difference for anxiety. Network analysis showed that, among Tai Chi practitioners, "Felt sadness", "Uncontrollable worrying" and "Trouble relaxing" were the most central symptoms. In contrast, among non-practitioners, the most central symptoms were "Felt sadness", "Uncontrollable worrying", and "Nervousness". Key bridge symptoms linking depressive and anxiety symptoms were "Worry too much", "Bothered by things" and "Uncontrollable worrying" in Tai Chi practitioners and "Nervousness", "Felt nervous/fearful" and "Sleep quality" in non-practitioners. This study underscored how practising Tai Chi is associated with reduced overall prevalence and severity of depression and different interactions of depressive and anxiety symptoms among older adults. Central and bridge symptoms differed between Tai Chi practitioners and non-practitioners.

Global trends and geographical disparities in the incidence of uterine cancer from 1990 to 2021

BACKGROUND

Social and economic factors play significant roles in the incidence of uterine cancer. This study examined how age, time period and birth cohort affect incidence patterns across various regions.

METHODS

Data on the incidence of uterine cancer from 1990 to 2021 were obtained from the Global Burden of Disease Study 2021. An age-period-cohort (APC) model was applied to evaluate the effects and geographical variations.

RESULTS

In 2021, there were 473,614 [95 % uncertainty interval (UI) 429,916-513,667] cases of uterine cancer globally, resulting in an age-standardized incidence rate (ASIR) of 10.4/100,000 (95 % UI 9.4-11.2). ASIR was highest in High-income North America and Europe (high-income regions), and lowest in South Asia and most African regions. The incidence of uterine cancer has surged disproportionately over time, especially in high-income regions and areas with rapid socio-economic changes. High-income Asia Pacific saw the fastest growth, with an annual net drift of 2.43 % (95 % confidence interval 2.29-2.57). Age is a critical determinant of the incidence of uterine cancer, with notable regional variation. Globally, the peak incidence of uterine cancer occurs at 70-74 years of age, or older, in most regions. However, earlier peaks in incidence are observed in East Asia and Asia Pacific (both 55-59 years), as well as Central Asia (60-64 years).

CONCLUSION

The incidence of uterine cancer is increasing globally, with marked geographical disparities in age distribution, temporal trends and cohort effects. While Europe and North America have the highest incidence rates globally, Asia faces a triple challenge: rising incidence, disproportionate caseloads, and younger age at diagnosis. Addressing geographical disparities is crucial in tackling the surge in cases of uterine cancer.

The Effect of Maternal Haemoglobinopathies and Iron Deficiency Anaemia on Foetal Growth Restriction: A Systematic Review and Meta-Analysis

Maternal anaemia is a significant global health issue that adversely affects both maternal and foetal outcomes, particularly, intrauterine growth restriction (IUGR). This systematic review and meta-analysis aimed to consolidate existing evidence on the impact of maternal anaemia on the risk of IUGR. We conducted a comprehensive search across PubMed, Embase, Cochrane and Web of Science until 28 February 2024. Eligible studies included observational designs that reported maternal anaemia and its association with IUGR or small for gestational age (SGA) outcomes. The pooled odds ratios (ORs) were calculated using a random-effects model and heterogeneity was assessed with the I² statistic. The R software (version 4.3) was used for statistical analyses. A total of 38 studies involving 3,871,849 anaemic and 27,978,450 non-anaemic pregnant women were included. The pooled analysis demonstrated that anaemia in pregnancy is associated with a significantly increased risk of IUGR (OR = 1.30, 95% CI: 1.05-1.62, I² = 97%). Subgroup analyses by anaemia severity showed non-significant associations for mild (OR = 0.84, 95% CI: 0.58-1.23) and moderate anaemia (OR = 0.98, 95% CI: 0.48-1.98), while severe anaemia indicated a higher, though non-significant, risk of IUGR (OR = 1.42, 95% CI: 0.69-2.93). Maternal anaemia is associated with a heightened risk of IUGR, highlighting the critical need for effective management and early intervention strategies within prenatal care settings. Future research should focus on elucidating the effects of different severities of anaemia on birth outcomes, including IUGR and long-term effects later in life.

Low and high air temperature and cardiovascular risk

Temperature extremes are one facet of global warming caused by climate change. They have a broad impact on population health globally. Due to specific individual- and area-level factors, some subgroups of the population are at particular risk. Observational data has demonstrated that the association between temperature and mortality and cardiovascular mortality is U- or J-shaped. This means that beyond an optimal temperature, both low and high temperatures increase cardiovascular risk. In addition, there is emerging epidemiological data showing that climate change-related temperature fluctuations may be particularly challenging for cardiovascular health. Biological plausibility for these observations comes from the effect of cold, heat, and temperature fluctuations on risk factors for cardiovascular disease. Shared mechanisms of heat and cold adaptation include sympathetic activation, changes in vascular tone, increased cardiac strain, and inflammatory and prothrombotic stimuli. The confluence of these mechanisms can result in demand ischemia and/or atherosclerotic plaque rupture. In conclusion, public health and individual-level measures should be taken to protect susceptible populations, such as patients with risk factors and/or pre-existing cardiovascular disease, from the adverse effects of non-optimal temperatures. This review aims to provide an overview of the association between temperature extremes and cardiovascular disease through the lens of pathophysiology and observational data. It also highlights some specific meteorological aspects, gives insight to the interplay of air temperature and air pollution, touches upon social dimensions of climate change, and tries to give a brief outlook into what to expect from the future.

Global demographic and etiological variations of retinal vasculitis: A systematic review and meta-analysis: International Uveitis Study Group (IUSG) Retinal Vasculitis Study (ReViSe) Report 1

This systematic review with meta-analysis explores the global demographic and etiological variations of retinal vasculitis (RV), focusing on differences in frequency, age, sex, and etiology across diverse geographic populations. RV is an inflammatory condition that can lead to visual impairment, making understanding its variations essential for targeted screening and management. Systematic searches were conducted in multiple databases up to February, 2023, following PRISMA guidelines. We included studies with at least 10 RV cases, such that a frequency measurement can be estimated, without restrictions on publication date or language. RV was categorized as Idiopathic RV in the absence of additional ocular or systemic disease, Syndromic RV for ocular involvement without systemic disease, and Secondary RV in those asssociated with systemic disease. The risk of bias was evaluated using standardized tools. A total of 95 studies, including 23,180 patients, were analyzed. The overall RV frequency among uveitis cohorts was 17 %, with European populations showing the highest frequency at 25 %. Idiopathic RV accounted for 1 % of uveitis cohorts and 38 % of RV cohorts, with significant differences across continents. Behçet disease had the highest RV frequency at 56 %. The median age of diagnosis was 33.5 years, and RV was more frequent in males (57 %). Our findings underscore the considerable geographic and demographic variability in RV, particularly in Idiopathic RV, tuberculosis-related RV, and Behçet disease, highlighting the need for tailored, region-specific, and gender-specific approaches to RV diagnosis and treatment.

Experiences and perspectives regarding developmentally appropriate cancer services for adolescents and young adults with cancer: A mixed methods systematic review

BACKGROUND

Providing developmentally appropriate cancer services for adolescents and young adults is a challenge for the health sector. Current service approaches are fragmented and diverse, with amalgamation of adolescents and young adults' perspectives lacking in the literature. Whilst there has been progress in delivering care focused on adolescents and young adults, contemporary evidence is warranted to understand their experience to establish sustainable developmentally focused cancer care.

OBJECTIVE

To examine the experiences and perspectives regarding developmentally appropriate cancer services for adolescents and young adults with cancer.

DESIGN

This systematic review was conducted in accordance with the Joanna Briggs Institute methodology for mixed methods systematic reviews using a convergent integrated approach. Studies focused on the care experiences of adolescents and young adults with a cancer diagnosis between the ages of 15 to 39 years were included in the review. A key word search of six relevant databases identified 2513 records and 57 full text records were screened for eligibility.

RESULTS

16 qualitative studies, 12 quantitative studies and two mixed method studies were included in the analysis. Four synthesised findings were generated from 10 categories. Findings were conceptualised as: Developmentally appropriate information and communication, Decision-making process, Relationship, emotions and comfort, and Care environment. Findings highlighted information provided was inappropriate at the time of diagnosis and inadequate during treatment period and survivorship. They desired direct, open communication with healthcare providers and expected guidance in certain instances, however, also sought autonomy in decision-making. The support of family, peers and care-providers was considered invaluable to effectively cope with stressors. The need for cultivating an empathetic healthcare environment suitable for young people was also identified as a significant need.

CONCLUSIONS

This review affirmed that although significant effort has been invested, further work is needed to improve the cancer care experiences of adolescents and young people. The findings emphasise many preferences regarding how cancer services should be delivered, suggesting that services should be evaluated against these preferences. Ensuring developmental appropriateness is critical for the delivery of supportive cancer care.

REGISTRATION NUMBER

CRD42023413864 (PROSPERO).

Inhalers or nebulisation of salbutamol in childhood asthma exacerbations in emergency departments

PURPOSE

Asthma exacerbations often lead to paediatric emergency department (PED) visits, but evidence for paediatric management remains limited, and recommendations under discussion. This study compared salbutamol delivered via nebulisation and pressurised metered dose inhalers (pMDI) with a holding chamber in children with mild to severe asthma exacerbations.

METHODS

A two-centre study was conducted during eight months, comparing hospitalisation rates, clinical improvement, side effects, and PED visit length in the overall population and in children under and over 6 years old.

RESULTS

A total of 384 patients were included, primarily with mild and moderate exacerbations of similar severity between groups. The discharge rate was comparable between groups in the overall population (82.7 % without any nebulisation in the pMDI group versus 81.6 %, p = 0.93), but higher for children under 6 years old treated with pMDI (98.1 % versus 76.9 %, p < 0.001). The pMDI group exhibited significantly lower hospitalisation rates (p < 0.001) and shorter PED visits (1.7 [1.2-2.6] hours versus 4.0 [2.6-5.3] hours, p < 0.001) while receiving lower salbutamol doses (0.10 [0.05-0.16] mg/kg versus 0.81 [0.55-1.18] mg/kg, p < 0.001) with less ipratropium and oral corticosteroids (p < 0.001 and p < 0.001). The pMDI group demonstrated fewer side effects, particularly oxygen dependence, especially in children under 6 (p < 0.001).

CONCLUSION

The study suggests that salbutamol via pMDI with a holding chamber is as effective as nebulisation for treating mild to moderate childhood asthma exacerbations. This approach results in fewer hospitalisations, reduced side effects, and shorter PED visits. Educating patients on pMDI use and efficacy could further decrease emergency visits for asthma exacerbation.

Status and Opportunities for Improvement in Pain Education in Europe: A European Pain Federation EFIC Multiple-Methods Study

BACKGROUND

Pain is one of the most prevalent health issues in Europe, yet the quality of pain education for healthcare professionals remains unclear. This study assessed the status of undergraduate and postgraduate pain education for nurses, physicians, psychologists, and physiotherapists across Europe, identifying key strategies to enhance training and improve healthcare outcomes.

METHODS

A study using multiple methods was conducted, comprising a scoping review, an online survey of educators, and qualitative interviews with EFIC chapters and professional educational bodies.

RESULTS

The scoping review of 11 studies revealed a paucity of evidence, with significant heterogeneity in the hours dedicated to pain training and inconsistencies in both content, teaching, and assessment methods across European curricula. The survey of educators (n = 511) showed wide variability in pain education coverage, with psychology curricula particularly underrepresented compared to the more structured programmes in medicine and physiotherapy. The interviews highlighted curriculum constraints, lack of resources, and limited specialised staff as key barriers. They also underscored the importance of integrating pain education across all disciplines through international and interdisciplinary collaboration to enhance training efforts.

CONCLUSIONS

Significant gaps persist in the depth, consistency, and delivery of pain education for undergraduate and postgraduate health professionals across Europe. The absence of standardised, evidence-based curricula underscores the need for consistent pain education across all disciplines. Implementing targeted educational standards, increasing interdisciplinary training, and supporting qualified educators are essential to address this fragmented landscape. Standardising pain education has the potential to greatly improve patient outcomes by equipping healthcare professionals with more effective pain management skills.

SIGNIFICANCE STATEMENT

This multiple method study provides an updated and comprehensive overview of the current state of pain education for healthcare professionals in Europe at undergraduate and postgraduate levels. Substantial gaps remain in the depth, consistency, and delivery of pain education for both undergraduate and postgraduate healthcare professionals across Europe. This underscores the need to enhance pain education at the undergraduate level, with EFIC's existing medicine and physiotherapy resources offering potential models, alongside wider efforts to implement comprehensive postgraduate training. Standardising the delivery of targeted pain education has the potential to greatly improve patient outcomes by equipping healthcare professionals with more effective pain management skills.

SII as a predictor of mortality in patients with non-ST-segment elevation myocardial infarction and diabetes mellitus

Background

Systemic immune inflammation index (SII) is an innovative marker reflecting immune and inflammatory responses.

Objectives

To explore the predictive value of SII on the risk of death in patients with NSTEMI combined with T2DM.

Methods

An analysis of 448 patients with NSTEMI and T2DM admitted to our institution between December 2017 and May 2022 was conducted in this retrospective study. SII values were used to divide patients into high and low SII groups and investigate their impact on mortality.

Results

According to the analysis results, elevated SII levels are significantly linked to a poor prognosis in patients with NSTEMI and T2DM. Over an average follow-up period of 22.75 months, 106 (23.7 %) all-cause deaths were recorded. The optimal threshold for predicting death was found to be an SII value of 1384.596 × 109/L through ROC curve analysis. Kaplan-Meier analysis indicated that the survival rates were higher in the low SII group compared to the high SII group (P < 0.001). Elevated SII levels were independently linked to increased mortality in patients with NSTEMI and T2DM, according to univariate (HR:3.19, 95 % Cl: 2.18-4.68) and multivariate COX (HR: 2.72, 95 % Cl: 1.81-4.09) regression analyses.

Conclusion

High SII values were strongly associated with mortality in patients with NSTEMI and T2DM. SII serves as a valuable prognostic tool, enhancing the management and prognosis of patients with concurrent NSTEMI and T2DM.

Purine xanthine oxidase inhibitors are not conducive to the prognosis of chronic heart failure: a meta-analysis

BACKGROUND

According to previous studies, the efficacy of xanthine oxidase inhibitors (XOIs) in patients with chronic heart failure (CHF) is still controversial. Therefore, the purpose of this study was to investigate the efficacy of XOIs in patients with CHF.

METHODS

Up to July 2024, we searched PubMed, EMBASE, Medline, Web of Science, and Cochrane Library for studies on the efficacy of XOI in patients with CHF. The main results included all-cause mortality, cardiovascular (CV) mortality, and heart failure (HF) hospitalization rates. The results were evaluated by hazard ratio (HR) and 95% confidence interval (95% CI).

RESULTS

A total of eight studies were included in this meta-analysis, of which five were cohort studies and three were randomized controlled trials (RCTs). The total sample size was 301,345. The experimental group was exposed to allopurinol or hydroxypurinol. The all-cause mortality (HR = 1.26, 95% CI 1.05-1.51, p = 0.013) and CV mortality (HR = 1.58, 95% CI 1.17-2.14, p = 0.03) in the experimental group were higher than those in the control group. In terms of HF hospitalization, there was no difference between both groups (HR = 1.21, p = 0.292). Subgroup analysis showed that the CV hospitalization rate of the experimental group was higher than that of the control group, regardless of frequency and dose levels. The all-cause mortality in the low-dose group was higher than that in the control group (HR = 1.39, p = 0.033). The CV mortality of the low-dose group (HR = 1.55, p = 0.006) and the prevalent group (HR = 1.50, p = 0.042) was higher than that of the control group.

CONCLUSION

Purine XOI exposure may be unfavorable for the prognosis of CHF patients and is affected by the frequency and dose of use.

High local type-2 inflammation is linked to response in severe asthma treated with anti-Interleukin-5 receptor

BACKGROUND

Benralizumab is an anti-IL-5 receptor (IL-5R) therapy linked to a huge improvement of the condition of patients with severe eosinophilic asthma. The goal of this study was to identify baseline airway markers of remission and response after anti-IL5R therapy.

METHODS

This observational study included 45 patients initiated with an anti-IL-5R. Remission was defined as: no oral corticosteroids intake, no exacerbation, a good asthma control (ACQ <1.5 and/or ACT >19) and a good lung function (FEV1 ≥ 80 % predicted and/or an improvement ≥10 %). Components of remission were also assessed individually to evaluate the response of patients. Sputum levels of mediators implicated in inflammation and remodeling were measured before treatment.

RESULTS

Among the 45 patients, 12 were classified in remission. These patients were younger at baseline, had a lower smoking exposure, better asthma control and quality of life and a higher FeNO compared to the others. Moreover, baseline blood eosinophil counts were similar but sputum IL-6 and IL-8 levels were significantly higher in the non-remission group. Finally, patients who only improved their ACT or ACQ score had higher baseline FeNO values or sputum eosinophil percentage respectively. Those who increased their FEV1 ≥ 10 % presented a higher baseline sputum eosinophil percentage, sputum eotaxin-3 level and a trend for a higher sputum IL-5 level.

CONCLUSION

High baseline airway T2 markers appeared to be associated with response to anti-IL-5R therapy. Lower sputum IL-6 and IL-8 levels were linked to remission. These results need to be validated in a bigger cohort.

Socioeconomic position and type 2 diabetes: Examining the mediating role of social cohesion-The Maastricht Study

The relationship between socioeconomic position and type 2 diabetes is well-established; individuals of lower socioeconomic position experience substantially higher rates of the disease. This study investigated the mediating role of perceived and ecometric area-level social cohesion in the association between socioeconomic position and incident type 2 diabetes. In a prospective population-based cohort, The Maastricht Study, we analyzed data from 6,604 participants (age¯ = 58.6 years, 55% female) with a median follow-up of 8.1 (IQR 5.1-10.1) years. We examined whether perceived or area-level social cohesion (in 500 m squares, five-character postal code areas, and neighborhood areas) mediated the association between socioeconomic position (represented by educational attainment, occupational status, or income) and incident type 2 diabetes. We employed a causal mediation approach based on linear regression and Cox proportional hazards models. Individuals with lower socioeconomic position were more likely to perceive lower social cohesion and to live in areas with diminished social cohesion. Lower area-level social cohesion was associated with an increased risk of developing type 2 diabetes. The mediating effect of social cohesion was more pronounced in urban areas. In urban areas, the total effect of education (contrasting the 83rd and 17th percentiles) on type 2 diabetes incidence was a hazard ratio (HR) of 2.03 (95% CI: 1.62-2.58), with area-level social cohesion mediating 24.4% (11.1%-40.3%) of this effect. In less urban areas, social cohesion mediated 12.6% (5.2%-23.0%) of a HR of 1.89 (1.50-2.40). Similar findings were observed with occupational status and income, and across other aggregation levels. Socioeconomic position is linked to lower social cohesion, which is associated with an increased risk of type 2 diabetes. Enhancing social cohesion in disadvantaged areas may help reduce diabetes-related health disparities, particularly in urban settings. Further research is needed to better understand the mechanisms underlying these relationships.

Intestinal IL-17 family orchestrates microbiota-driven histone deacetylation and promotes Treg differentiation to mediate the alleviation of asthma by Ma-Xing-Shi-Gan decoction

BACKGROUND

Gut microbiota imbalance is well-known as one important trigger of allergic asthma. Ma-Xing-Shi-Gan decoction (MXSG) is a traditional Chinese medicine prescription with ideal clinical efficacy on asthma. However, whether and how MXSG exerts its efficacy on asthma through gut microbiota remains unclear.

PURPOSE

To investigate the underlying mechanism of MXSG against asthma using multi-omics technologies.

METHODS

An asthma model was established using 8-week-old C57BL/6 J mice, after which they were daily administrated with high-, medium- and low-dose MXSG for 7 days. Histopathological examinations and flow cytometry were performed to evaluate the effects of MXSG on lung immune injury. Key regulatory pathways were predicted via network pharmacology and verified using 16S rRNA sequencing, metagenomics, metabolomics, and in vivo experiments including the knockout of the targeting gene.

RESULTS

MXSG alleviated asthma symptoms, elevated intestinal microbial diversities, and enriched potential beneficial microbes such as Lactococcus, Lactobacillus, and Limosilactobacillus. Network pharmacology and experimental validation highlighted the IL-17/Treg signaling as crucial for asthma treatment. IL-17 knockout experiments revealed its necessity for Treg differentiation during asthma. Moreover, IL-17-deficient asthmatic mice exhibited lower levels of Lactobacillus and significant changes in microbial genes involving histone deacetylases (HDAC) and short-chain fatty acids (SCFAs). Finally, MXSG significantly boosted SCFA production and reduced HDAC9 expression, which were correlated with Treg cell ratios.

CONCLUSION

Our study delineates a novel mechanism where MXSG synergizes with the IL-17 family to enrich intestinal beneficial microbes (e.g. Lactobacillus) and SCFAs. This inhibits the expression of SCFA-downstream HDAC9 to promote Treg differentiation, and thus potentially alleviates asthma.

Childhood Smoking Initiation, Genetic Susceptibility, and Incident Cardiovascular Diseases in Adulthood

PURPOSE

We aimed to assess the associations of age of smoking initiation and polygenic risk scores (PRSs), individually and jointly, with the incidence of overall cardiovascular diseases (CVDs), coronary artery disease (CAD), atrial fibrillation (AF), and stroke in adulthood.

METHODS

Multivariable-adjusted accelerated failure time models were used to assess the impacts of age of smoking initiation and PRSs on incident overall CVDs, CAD, AF, and stroke in adulthood and to examine their joint effect on these outcomes.

RESULTS

Compared with never smokers, the time ratio (TR) with a 95% confidence interval (CI) for incident overall CVDs was 0.80 (0.78-0.82) among participants who initiated smoking at age 5-14 years, and 0.85 (0.84-0.86) at age 15-17 years. The corresponding TRs (95% CIs) for CAD were 0.74 (0.72-0.76) and 0.81 (0.79-0.83), respectively; for AF were 0.89 (0.86-0.91) and 0.91 (0.89-0.93), respectively; and for stroke were 0.84 (0.80-0.87) and 0.87 (0.85-0.90), respectively. Notably, participants with high PRSs who initiated smoking at age 5-14 years (vs. never smokers with low PRSs) were the fastest ones to develop overall CVDs (TR = 0.63, 95% CI = 0.61-0.65), CAD (TR = 0.48, 95% CI = 0.46-0.51), AF (TR = 0.55, 95% CI = 0.53-0.57), and stroke (TR = 0.70, 95% CI = 0.66-0.75).

DISCUSSION

Smoking initiation in childhood significantly accelerated the incidence of overall CVDs, CAD, AF, and stroke in adulthood. Of note, participants with high genetic susceptibility who initiated smoking in childhood had the earliest onset time of CVDs later in life.

Allergic-related skin diseases: Global disease burden from 1990 to 2021 and future trends

Background

Allergic-related skin diseases, including atopic dermatitis (AD), urticaria, and contact dermatitis (CD), are significant global public health challenges. Currently, there is a lack of systematic analysis of allergic-related skin diseases globally.

Methods

This study aimed to quantify the global burden of AD, CD, and urticaria and evaluate their global epidemiology patterns. The Global Burden of Diseases (GBD) database was used to assess incidence, prevalence, and disability-adjusted life years (DALYs) for these allergic-related skin diseases. Additionally, the Bayesian Age-Period-Cohort (BAPC) model was employed to predict disease burden for the next 15 years.

Results

From 1990 to 2021, cases of AD, CD, and urticaria rose steadily. In 2021, AD prevalence reached 129 million, a 20.02% increase from 1990. However, average annual percentage change (AAPC) values for the age-standardized prevalence rate (ASPR) of AD declined constantly (AAPC = -0.28). CD had the highest incidence, with 253 million new cases in 2021, though AAPC for ASPR of CD showed minimal changes. AD and urticaria peaked in early life, while CD peaked at ages 75-79. Moreover, AD had the strongest positive correlation with the Socio-demographic Index (SDI) (p = 2.2e-16, ρ = 0.626). AD, CD, and urticaria show the highest age-standardized rate in high, middle, and low-middle SDI regions, respectively, with all 3 conditions declining in high SDI. Health inequality analysis showed AD's burden is now more evenly distributed across SDI groups, while the global burden gap for urticaria and CD change limitedly.

Conclusion

Although the global disease burden of allergic-related skin diseases continues to rise, the overall age-standardized rates of AD have steadily declined and are projected to decrease further. In contrast, CD and urticaria require increased attention.

Depressive disorders attributable to childhood sexual abuse and bullying victimization: Temporal trends and socio-demographic inequalities

BACKGROUND

Childhood sexual abuse and bullying victimization are critical risk factors for depressive disorders, contributing significantly to the global health burden. This study evaluates the global, regional, and national burden of depressive disorders attributable to these factors from 1990 to 2021, focusing on trends, age and sex disparities, and socio-demographic inequalities.

METHODS

Using Global Burden of Disease 2021 data from 204 countries, we measured the burden in disability-adjusted life years (DALYs) with 95 % uncertainty intervals (UI). Temporal trends were assessed via estimated annual percentage change (EAPC), with COVID-19-related changes represented by percentage change. Socio-demographic influences were examined using the Socio-demographic Index and inequality indices. Future trends were forecasted using Bayesian models.

RESULTS

The global age-standardized DALYs rate (ASDR) for depressive disorders attributable to childhood sexual abuse was 18.08 (95 % UI: 8.75-30.97) per 100,000 population, while bullying victimization accounted for 44.32 (95 % UI: 18.72-83.89). From 1990 to 2021, the burden linked to childhood sexual abuse decreased, whereas bullying victimization steadily increased. Females experienced a higher burden from childhood sexual abuse, while bullying-related depressive disorders peaked in males aged 15-24. In 2021, depressive disorders attributable to childhood sexual abuse displayed negative slope index of inequality values (-14.42, 95 % confidence intervals: -19.04 to -9.80). By 2035, ASDRs for both factors are projected to increase by 37-50 %.

CONCLUSIONS

This study highlights the substantial burden of depressive disorders due to childhood trauma, emphasizing the need for tailored interventions, equitable mental health care, and global collaboration to address these challenges.

Children and adolescents' demand for psychiatric services: Insight from the a nine-year-period visits population change in Nanjing, China

BACKGROUND

The prevalence of mental health issues among children and adolescents has been increasing. The objective of this study is to delineate the evolving characteristics of psychiatric visits among this demographic, including sex differences in service utilization, and to evaluate the capacity of existing medical resources to meet their needs for such visits.

METHODS

The data were sourced from Nanjing Brain Hospital and retrieved from outpatient and inpatient records of individuals aged 18 and below who visited the psychiatric department between the dates of July 2015 and June 2024. A descriptive analysis of the temporal changes in clinical features and general data was conducted, and an ETS time series model was employed to forecast whether visit demands are being met.

RESULTS

A total of 594,510 visits were recorded across both outpatient and inpatient systems. The overall number of visits increased year by year, with the fastest growth rate among patients with mood disorders. Furthermore, the growth rate of boys was significantly slower than that of girls (outpatient: OR = 0.93, P < 0.001; inpatient: OR = 0.91, P < 0.001). The ETS time series analysis indicated that future visit trends are expected to stabilize, with a significant proportion of children and adolescents still requiring N-CAP visits (outpatient: 31 %; inpatient: 44 %). In the inpatient system, the majority of this population is concentrated in the 17-18 age group (73 %).

CONCLUSION

The number of psychiatric visits for children and adolescents has been increasing on an annual basis. The current medical resources are insufficient to meet the growing demand.

Qingre Sanjie Formula alleviates atherosclerosis by promoting LXR-α/ABCG5/G8-mediated reverse cholesterol transport and bile acid synthesis

BACKGROUND

Atherosclerosis is the leading cause of cardiovascular disease-related morbidity and mortality. The traditional Chinese medicine Qingre Sanjie Formula (QRSJF), composed of Prunellae Spica, Sargassum, Fritillariae Thunbergii Bulbus, Leonuri Herba, and Forsythiae Fructus, has shown efficacy in treating cardiovascular diseases, although its mechanisms are unclear.

PURPOSE

This study aimed to explore the protective effects of QRSJF against atherosclerosis and the mechanisms involved.

METHODS

The composition of QRSJF was analyzed using Ultra Performance Liquid Chromatography Quadrupole Time-of-Flight Mass Spectrometry. An 8-week high-fat diet (HFD)-induced atherosclerosis model was established in ApoE-/- mice. Following model induction, mice received 12 weeks of QRSJF treatment at high- and low doses (3.16 and 1.58 g drug/kg/day, respectively) via oral gavage, while simvastatin (2.6 mg/kg/day) as the positive control. Various techniques, including biochemical assays, vascular ultrasonography, histopathology, untargeted metabolomics, and molecular biology techniques were utilized to evaluate therapeutic effects. The underlying mechanism was investigated in vitro using free fatty acids -induced HepG2 cells.

RESULTS

Both low- and high-dose QRSJF effectively attenuated dyslipidemia and decreased serum inflammatory cytokine levels in HFD-fed ApoE-/- mice. In addition, QRSJF alleviated atherosclerotic plaque formation, reduced arterial narrowing, and enhanced plaque stability. Plasma and liver metabolomic analyses further identified that ABC (ATP binding cassette) subfamily transporters and bile acid metabolism as key pathways through which QRSJF ameliorates atherosclerosis. QRSJF also alleviated liver lipid accumulation and increased the expression of liver proteins, including scavenger receptor class B type 1, low-density lipoprotein receptor, ABC subfamily A member 1, cholesterol 7α-hydroxylase (CYP7A1), ABC transporter G5/G8 (ABCG5/G8), bile salt output pump, and liver X receptor alpha (LXR-α). In vitro, QRSJF activated LXR-α expression in HepG2 cells, thereby enhancing the expression of the downstream targets, CYP7A1 and ABCG5/8, and reducing free fatty acid-induced lipid accumulation. Notably, the beneficial effects of QRSJF were abrogated by the LXR-α inhibitor GSK2033.

CONCLUSION

QRSJF improves dyslipidemia and reduces atherosclerotic plaque in ApoE-/- mice by activating the LXR-α/ABCG5/G8 pathway. This facilitates cholesterol transport to the liver and promotes bile acid synthesis and cholesterol excretion into the bile and intestine, thereby exerting anti-atherosclerotic effects.

Inhibition of the cGAS-STING pathway: contributing to the treatment of cerebral ischemia-reperfusion injury

The cGAS-STING pathway plays an important role in ischemia-reperfusion injury in the heart, liver, brain, and kidney, but its role and mechanisms in cerebral ischemia-reperfusion injury have not been systematically reviewed. Here, we outline the components of the cGAS-STING pathway and then analyze its role in autophagy, ferroptosis, cellular pyroptosis, disequilibrium of calcium homeostasis, inflammatory responses, disruption of the blood-brain barrier, microglia transformation, and complement system activation following cerebral ischemia-reperfusion injury. We further analyze the value of cGAS-STING pathway inhibitors in the treatment of cerebral ischemia-reperfusion injury and conclude that the pathway can regulate cerebral ischemia-reperfusion injury through multiple mechanisms. Inhibition of the cGAS-STING pathway may be helpful in the treatment of cerebral ischemia-reperfusion injury.

Using a difficult-to-treat resistance index to gauge imbalance between countries' antibiotic resistance prevalence and access to antibiotics: a scoping review and concept proposal

BACKGROUND

Inferring the impact of antimicrobial resistance on patient outcomes is challenging, given the variability in antibiotic access across countries and over time. By denoting resistance to all highly safe and effective antibiotics, the difficult-to-treat resistance (DTR) definition offers a framework for such assessments globally.

OBJECTIVES

This study aims to conduct a scoping review to understand the international adoption, scalability, and prognostic utility of DTR and enable solutions to incorporate antibiotic access into the DTR framework.

METHODS

Data sources: Data sources included Agricola, Embase, Global Index Medicus, PubMed, Scopus, Web of Science: BIOSIS and Core Collection.

STUDY ELIGIBILITY CRITERIA

Study eligibility criteria included original research publications occurring after January 2018 using the term 'difficult-to-treat resistance' to describe antimicrobial-resistant bacterial isolates demonstrating resistance to all first-line antibiotics (i.e. all β-lactam and fluoroquinolone antibiotics).

ASSESSMENT OF RISK OF BIAS

Assessment of risk of bias included Joanna Briggs Institute critical appraisal tool.

METHODS OF DATA SYNTHESIS

We assessed the overall themes of the included studies and classified them into epidemiological, mortality, or antibiotic effectiveness/efficacy studies. Semiquantitative results among studies evaluating the prevalence of resistant bacterial isolates and mortality were reported. We propose a 'DTR index' (DTRi) that extends beyond gram-negative bacteria and complements DTR by estimating national proportions of bacterial isolates resistant to all first-line antibiotics available specifically in that country.

RESULTS

DTR was utilized in 57 studies spanning 94 countries. The DTR definition was predominantly applied unmodified and retained prognostic utility in 70% of studies. The variability in access to first-line antibiotics and emergence of newer agents across countries and over time influence practical treatment options that cannot be captured by 'fixed' DTR definitions underscoring the value of the proposed DTRi.

CONCLUSIONS

The DTRi could appraise the clinical impact of introducing new agents in a country, identify hot zones of resistance-access imbalance, and optimize resource allocation to improve antibiotic resistance outcomes, especially in under-resourced populations.

Association of whole and refined grains food consumption with coronary artery disease in a multi-center, case-control study of Iranian adults: Iran Premature Coronary Artery Disease (IPAD)

BACKGROUND AND AIMS

Low whole grain food consumption is the leading cause of coronary artery disease (CAD) burden in middle-East countries. However, investigations examining the association of whole and refined grain foods and CAD are scarce in this region. We aimed to investigate the association of whole and refined grain foods with CAD in Iranians with different ethnicities.

METHODS AND RESULTS

This was a multi-center case-control study among Iranian ethnicities consisting of Fars, Azari, Kurd, Arab, Lor, Gilak, Qashqaei, and Bakhtiari within the framework of the Iran premature coronary artery disease (IPAD) project. The data were collected from hospitals with catheterization laboratories. Cases were 2099 patients with a stenosis ≥75 % in at least one vessel or ≥50 % in the left main artery. Control group were 1168 individuals with normal angiography test. Grains intake was assessed using a validated semi-quantitative food frequency questionnaire. Compared with those with the lowest intake of whole grain foods, subjects in the top quartile had lower risk of CAD (OR = 0.54, 95 % CI: 0.40, 0.72; P < 0.001) after full adjustment. However, a significant direct link was found between higher refined grain foods consumption and the risk of CAD (OR = 1.43, 95 % CI: 0.91-1.84; P = 0.013).

CONCLUSION

Our findings support dietary recommendations to increase whole grain foods and mitigating refined grain food consumption to reduce the risk of CAD and its severity.

Advancing network meta-analysis in non-invasive brain stimulation: Optimizing post-stroke mood through combined therapies

BACKGROUND

Post-stroke depression and anxiety significantly impact recovery and quality of life. Non-invasive brain stimulation (NIBS) techniques, including transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and transcranial ultrasound stimulation (TUS), have emerged as promising therapeutic options. However, the relative efficacy of single and combined NIBS therapies remains unclear. This network meta-analysis aims to identify the most effective combination therapies for optimizing post-stroke mood disorders.

NEW METHOD

A systematic search was conducted across PubMed, Embase, Cochrane Library, Web of Science, and key Chinese databases to identify randomized controlled trials (RCTs) published up to March 2023. Two independent reviewers screened the studies, extracted relevant data, and assessed the risk of bias using the Cochrane Handbook. A network meta-analysis was performed using Stata SE version 15.1 and R software version 4.2.3 to evaluate the comparative effectiveness of different NIBS interventions.

RESULTS

A total of 50 RCTs involving 3852 participants and 18 different interventions (including 11 combination therapies) were analyzed. The findings revealed: COMPARISON WITH EXISTING METHODS: Unlike previous studies focusing on single-modality interventions, this network meta-analysis systematically evaluates the comparative effectiveness of various combined NIBS strategies. Results indicate that combination therapies significantly outperform single-modality treatments, with TMS-based protocols showing the greatest overall benefit in improving both mood disorders and functional independence.

CONCLUSIONS

The findings suggest that optimized combination NIBS therapies offer superior outcomes for post-stroke depression and anxiety. HFrTMS_LFrTMS_WM was the most effective for depression and independence in activities of daily living (ADLs), while tDCS_psychotherapy and TUS_WM were particularly effective for anxiety. These results highlight the clinical potential of integrated NIBS strategies for post-stroke mood optimization and call for further research to refine treatment protocols for enhanced patient outcomes.

Impact of Intermittent Theta Burst Stimulation on Pain Relief and Brain Connectivity in Chronic Low Back Pain

BACKGROUND

This randomised clinical trial investigated the effect of intermittent theta burst stimulation (iTBS) over the dorsolateral prefrontal cortex (DLPFC) on pain alleviation in patients with chronic low back pain (CLBP) and its underlying mechanisms.

METHODS

Forty CLBP patients were randomly assigned to receive either active or sham iTBS combined with core stability exercise. Pain assessments were completed before and after the intervention. Eleven patients from each group underwent resting-state functional magnetic resonance imaging scans pre- and post-intervention to analyse DLPFC activation and connectivity with other brain regions.

RESULTS

The active iTBS group had a greater pain reduction than the sham group (p = 0.05, 95% CI: -0.009 to 1.109). In the active and sham groups, 80% (16/20) and 40% (8/20) reached the minimal clinically important difference, respectively, with a number needed to treat of 2.5. For the Fear-Avoidance Beliefs Questionnaire, there was a significant difference between the two groups (p = 0.011, r = 0.40). The active iTBS group showed a significantly enhanced functional connectivity between the left DLPFC and the right cerebellum, as well as both occipital gyri (voxel-level, p < 0.001; cluster-level familywise error rate, p < 0.01). Spearman's correlation analysis showed a significant negative correlation between Numerical Rating Scale and the FC of the left DLPFC and the right cerebellum (rho = -0.55, p = 0.008), the right (rho = -0.439, p = 0.01), and left occipital gyri (rho = -0.45, p = 0.034).

CONCLUSION

iTBS may alleviate pain in CLBP patients by enhancing DLPFC connectivity with the cerebellum and occipital gyrus.

SIGNIFICANCE

This study showed a facilitatory effect of iTBS on alleviating CLBP, which might be modulated by brain functional connectivity. Trial Registration Chinese Clinical Trial Registry: ChiCTR2200064899.

Temporal Associations of Physical Activity With Subsequent Knee Pain in Individuals With Knee Osteoarthritis: An Ecological Momentary Assessment Study

BACKGROUND

Physical activity (PA) is a first-line treatment for knee osteoarthritis and provides benefits for functional improvement and pain relief. However, movement-evoked pain often hinders PA participation and long-term adherence. The relationship between PA and pain is not fully understood and may vary across individuals. We examined the temporal associations between PA and subsequent knee pain in individuals with knee osteoarthritis.

METHODS

In a 10-day ecological momentary assessment (EMA) cohort study, PA was recorded using an Actigraph accelerometer; momentary knee pain intensity was rated on a numeric rating scale in responses to four daily text prompts. Linear mixed-effects models examined within-day and between-day associations between PA and knee pain, adjusting for age, sex and BMI.

RESULTS

The sample included up to 454 observations across 10 days from 17 participants (age = 64 ± 7 years, BMI = 27 ± 4 kg/m2, 61% women), each consisting of a temporal pair of PA minutes and subsequent momentary pain. Within-day, greater moderate-to-vigorous PA (MVPA) minutes were associated with a subsequent increase in knee pain (adjusted β = 0.112, 95% CI: 0.023, 0.201, p = 0.014); while light-intensity PA showed no association with subsequent pain (adjusted β = -0.003, 95% CI: -0.011, 0.005, p = 0.461). Current-day MVPA and light-intensity PA minutes were not associated with next-day knee pain.

CONCLUSIONS

While MVPA may temporarily increase knee pain, its impact was transient. Light-intensity PA showed no association with pain, suggesting it may be a suitable alternative for those with movement-evoked pain. Understanding these temporal patterns can help guide tailored pain management and PA adherence strategies. Further research is needed to confirm these preliminary findings.

SIGNIFICANCE STATEMENT

Understanding the dynamic relationship between PA and knee pain is crucial for optimising the management of knee OA. This exploratory study offers new insights by leveraging high-frequency data to examine the intra- and inter-day associations of MVPA and light-intensity PA with subsequent knee pain. The preliminary findings demonstrate that MVPA may lead to transient pain increases, while light-intensity PA is not associated with pain intensity. Identifying these PA-pain temporal patterns can inform personalised strategies for pain management and improving long-term activity adherence.

Targeting Ketone Body Metabolism Improves Cardiac Function and Hemodynamics in Patients With Heart Failure: A Systematic Review and Meta-Analysis

CONTEXT

The impacts of elevated ketone body levels on cardiac function and hemodynamics in patients with heart failure (HF) remain unclear.

OBJECTIVE

The effects of ketone intervention on these parameters in patients with HF were evaluated quantitatively in this meta-analysis.

DATA SOURCES

We searched the PubMed, Cochrane Library, and Embase databases for relevant studies published from inception to April 13, 2024. Ketone therapy included ketone ester and β-hydroxybutyrate intervention.

DATA EXTRACTION

Seven human studies were included for the quantitative analysis.

DATA ANALYSIS

Our results showed that ketone therapy significantly improved left ventricular ejection fraction (standardized mean difference, 0.52 [95% CI, 0.25-0.80]; I2 = 0%), cardiac output (0.84 [95% CI, 0.36-1.32]; I2 = 68%) and stroke volume (0.47 [95% CI, 0.10-0.84]; I2 = 39%), and significantly reduced systemic vascular resistance (-0.92 [95% CI, -1.52 to -0.33]; I2 = 74%) without influencing mean arterial pressure (-0.09 [95% CI: -0.40 to 0.22]; I2 = 0%) in patients with HF. Subgroup analysis revealed that the enhanced cardiac function and favorable hemodynamic effects of ketone therapy were also applicable to individuals without HF.

CONCLUSIONS

Ketone therapy may significantly improve cardiac systolic function and hemodynamics in patients with HF and in patients without HF, suggesting it may be a promising treatment for patients with HF and also a beneficial medical strategy for patients without HF or healthy individuals.

The Association Between Exclusive Breastfeeding and Diarrhoea Morbidity in Infants Aged 0-6 Months: A Rapid Review and Meta-Analysis

Diarrhoea remains a major cause of mortality among children under five, despite global efforts to reduce childhood morbidity and mortality. Exclusive breastfeeding (EBF) has been recognised as an effective and cost-effective intervention to reduce diarrhoeal disease burden in infants. This rapid review and meta-analysis aimed to assess the association of EBF on diarrhoea morbidity in early childhood, a critical period for growth and development, while addressing existing gaps by employing standardised definitions of EBF. A systematic search was conducted in Medline, Scopus, Embase, and Web of Science databases for studies published between 2010 and 2024. Seventeen studies met inclusion criteria and underwent quality assessment using the Joanna Briggs Institute (JBI) critical appraisal tool. Data from the identified studies were extracted, and a meta-analysis was conducted using random effects models to calculate the pooled effect size, with odds ratios (OR) and 95% confidence intervals (CI). This review found that EBF significantly reduces the risk of diarrhoeal diseases in infants under 6 months of age across diverse geographical regions and study designs. The meta-analysis of the association between exclusive breastfeeding and diarrhoea in infants aged 0-6 months resulted in a pooled OR of 0.57 (95% CI: 0.51, 0.63; I² = 57.66%). These findings underscore the critical role of promoting and supporting EBF as a pivotal public health strategy to enhance early childhood health outcomes and contribute to achieving global child health goals.

Nutritional and Psychological Support as a Multidisciplinary Coordinated Approach in the Management of Chronic Liver Disease: A Scoping Review

OBJECTIVES

This review emphasizes a novel, multidisciplinary, coordinated approach in the management of chronic liver diseases (CLDs).

BACKGROUND

Chronic liver diseases represent a significant global health burden, marked by a notable shift in the prevalence patterns from virus-related to metabolic and alcohol-related entities. Malnutrition, frailty, and sarcopenia exert a substantial impact on patients with cirrhosis, affecting 75%-90% of cases and escalating as the disease progresses. The European Association for the Study of the Liver recommends a comprehensive approach to nutritional care, emphasizing the need for detailed assessments in patients with cirrhosis, using diverse tools such as computed tomography scans, bioelectrical impedance analysis, and evaluations of muscle function. Considering the prevalence of nutritional and psychological disorders in the CLD population, the treatment of these patients should be founded indispensably on a multidisciplinary approach.

METHODS

A systematic search was conducted of the PubMed, MEDLINE, and SCOPUS databases to identify trials investigating the health effects of nutritional and psychological assessments in patients with CLD.

RESULTS

In dealing with the treatment of patients with CLD, an exploration of the psychological domain emerges as crucial, because psychological distress, especially depression, exerts a tangible influence on patient outcomes. Thus, the engagement of psychologists and/or psychotherapists, who might use techniques such as cognitive behavioral therapy, could enhance patients' comprehension of nutritional implications in their treatment and make them more aware of their illness.

CONCLUSION

The review emphasizes the relevance of both nutritional and psychological assessments in patients with CLD that could improve patient education on the pivotal role of nutrition in disease management. Randomized controlled trials evaluating the combined impact of nutritional and psychological support are recommended to further investigate this complex clinical landscape.

Impact of a cancer diagnosis on educational, employment, health-related quality of life, and social outcomes among young adults: A matched cohort study of 401 cancer survivors aged 15-24 in England

BACKGROUND

Globally, cancer incidence is rising fastest among young people. Existing literature on acute health shocks, including cancer diagnoses, focuses on older working-aged adults.

METHODS

Matched cohort study involving 401 young cancer survivors (aged 15-24) in the BRIGHTLIGHT study and 765 UK Household Longitudinal Study controls without cancer between 2013 and 2018. Participants were matched on sex, age, ethnicity, index of multiple deprivation (IMD) quintile, non-cancer health conditions, and follow-up duration. Regression models assessed economic, educational, social, health-related quality of life (HRQoL), and mental health outcomes at 6(T1), 12-18(T2), and 24-36 months (T3) post-diagnosis.

RESULTS

Compared to matched controls, those with cancer were: less likely to be in employment, education, or training at T1 (OR = 2.03, p < 0.001) but not at T3 (OR = 0.96, p = 0.18), because transitioning from unemployment or economic inactivity into education was more common (24 % vs 3 % between T1 and T3); less likely to live in parental households at T1 (OR = 0.54, p < 0.001) and T3 (OR = 0.59, p < 0.001); and more likely to experience relationship breakdown (23 % vs 12 % between T1 and T3). Differences in mental health and HRQoL declined over time (mean difference compared to matched controls: T1: -0.07, p < 0.001; T2 and T3: -0.01 p ≥ 0.55). Economic outcomes, mental health and HRQoL utility scores were persistently worse among more severe cancer cases.

CONCLUSIONS

Despite having initially poorer health and economic outcomes, cancer survivors in this cohort caught up with their peers within 3 years. Linked clinical data showed those with more severe diagnoses were affected most, indicating scope for improved psychosocial and economic support.

Effects of hyperbaric oxygen combined with Danhong injection on 90-day functional independence and the 1-year recurrence rate in patients with ischemic stroke: A matched cohort study

BACKGROUND

Both hyperbaric oxygen therapy and Danshen (Salvia miltiorrhiza) injection have shown potential therapeutic effects on ischemic stroke, but the impact of their combination on long-term functional outcomes and recurrence risk has not been systematically evaluated. This study aimed to assess the effects of hyperbaric oxygen combined with Danhong injection on 90-day functional independence and the 1-year recurrence rate in patients with ischaemic stroke.

METHODS

This study employed a retrospective matched cohort design and collected data from patients with ischemic stroke treated at our hospital between January 2018 and December 2022. After 1:1 propensity score matching, 80 patients were included in each group. The intervention group received hyperbaric oxygen therapy (2.0-2.5 ATA, once daily for 10 sessions) combined with Danhong injection (20 ml/day for 14 consecutive days) in addition to standard treatment; the control group received standard treatment only. The primary outcome was 90-day functional independence (mRS ≤2); secondary outcomes included the 1-year stroke recurrence rate, NIHSS score improvement, and others.

RESULTS

The percentage of 90-day functional independence in the intervention group (72.5 %) was significantly greater than that in the control group (53.8 %) (P = 0.014), with a relative risk ratio of 1.35 (95 % CI: 1.06-1.71). Multivariate analysis revealed that combined therapy was independently associated with 90-day functional independence (adjusted OR = 2.28, 95 % CI: 1.19-4.37; P = 0.013). The 1-year stroke recurrence rate in the intervention group (7.6 %) was significantly lower than that in the control group (16.5 %) (P = 0.042), with an adjusted hazard ratio of 0.46 (95 % CI: 0.22-0.94, P = 0.033). Subgroup analysis revealed that patients aged <65 years, those with NIHSS scores ranging from 4-15, those with small-artery occlusion or large-artery atherosclerosis stroke, and those who began treatment within 24 hours benefited more significantly. The combined therapy was well tolerated, with no serious adverse events.

CONCLUSION

Hyperbaric oxygen combined with Danhong injection significantly improved 90-day functional independence and reduced the 1-year recurrence risk in patients with ischaemic stroke, particularly in specific patient subgroups. This combined treatment strategy provides a new therapeutic option for comprehensive stroke management.

Efficacy of Mitochondrial Transfer in Healing Toxin-Induced Damage to Neuromuscular Junction, an Empirical Study

Neuromuscular diseases and damage affect many people of all ages and are responsible for an exorbitant medical cost, more than $200 million annually. Accordingly, finding an appropriate model to investigate potential curative interventions is necessary. One currently used involves the application of toxic agents on skeletal muscle followed by mitochondrial transplant therapy. A question regarding this model is whether such toxins impact not only muscle tissue but also the neuromuscular junctions (NMJs) responsible for exciting the muscle tissue. This question was addressed here by forming four experimental groups of C57BL/six mice (10-14 per group) that were 8-12 weeks of age: 1) controls whose muscles had not been injured or treated, 2) muscles taken from mice that were injured and then treated with mitochondrial supplement, 3) muscles that had not been injured but were still treated with mitochondria, and 4) muscles that were injured and received no mitochondrial treatment. Several pre- and postsynaptic features of NMJs were subject to immunofluorescent staining procedures before having morphological features assessed with confocal microscopy. Results revealed that only postsynaptic acetylcholine (ACh) receptors showed any significant (p < 0.05) between-group differences, including decreased area size and perimeter length around ACh receptor clusters in injured NMJs. However, presynaptic nerve terminal branching was not different (p > 0.05) among treatment groups, and structural features were not different between groups with the exception of dispersion of postsynaptic receptors. Overall, these results suggest that skeletal muscles damaged with toxin accurately mimic what occurs during toxin-induced damage and post-injury recovery and can be used as a faithful model of occurrences during damage to NMJs as a result of muscle damage along with recovery from that insult.

Moderate drinking benefits cognitive health in middle-aged and older Chinese: A latent class growth model analysis based on CHARLS

While alcohol use among older population is linked to various health risks, recent studies indicate potential benefits from moderate consumption, highlighting a contentious debate regarding its impact on health in this demographic. This study aims to identify distinct trajectories of alcohol use among middle-aged and older adults in China and examine their associations with multidimensional health outcomes, including cardiovascular, cognitive, and psychological health. This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), tracking a sample of 10,927 participants (54.33 % female; mean age = 57.61, SD = 8.95) through five waves of data collection. Latent Class Growth Modeling (LCGM) was employed to analyze alcohol use trajectories. Health outcomes were assessed through self-reported health measures and clinical data including lipoprotein levels. Four distinct alcohol use trajectories were identified: Moderate (6.3 %), Decreasing (11.0 %), Increasing (6.9 %), and Constantly Low (75.8 %). The Moderate trajectory was associated with significant higher cognitive scores compared to Increasing (p = .027) and Constantly Low group (p = .012). Moreover, higher levels of high density lipoprotein were linked with the Increasing and Decreasing trajectories, suggesting a protective cardiovascular effect. The findings highlight the complexity of alcohol use behaviors among older adults in China and underscore the need for targeted health interventions. Understanding the nuanced impacts of different drinking patterns on multidimensional health outcomes can aid in developing more effective public health strategies and clinical practices tailored to the needs of aging populations. Further research is recommended to explore the causal relationships and long-term health impacts of these trajectories.

Effects of mindfulness- and acceptance-based interventions for individuals with schizophrenia spectrum disorders: A systematic meta-review

BACKGROUND

Mindfulness- and acceptance-based interventions (MBIs/ABIs) for persons with schizophrenia spectrum disorders (SSD) aim to cultivate purposeful attention, mind-body awareness, and targeted action-taking. This systematic meta-review assessed the current body of evidence regarding the effects of MBIs/ABIs for SSD symptoms.

METHODS

The study was registered with PROSPERO (CRD42024535284) on June 3, 2024. Seven databases were searched between April 18 and April 19, 2024. Meta-analyses investigating the effects of MBIs/ABIs for SSD symptoms were considered. Two authors (AM, AS) independently completed data extraction and analysis. Evidence grading and methodology assessments were conducted using the Ioannidis' criteria, AMSTAR-2, and AMSTAR-Plus Content guidelines.

FINDINGS

A total of 18 meta-analyses with up to 2572 participants were considered; 14 studies were eligible for analysis. Results were classified according to Ioannidis' criteria; the effect size of the highest ranked study with the largest number of primary studies is presented. Percentages indicate the number of studies reporting significant results. Significant evidence was found at end of treatment for overall symptomatology (MBIs: 100 %, n = 9, g = -0·7 (total range: -0·417 to -1·152), 95% CI: [-1·052, -0·347], I2 = 95·36; ABIs: 25 %, n = 29, g = -1·065 (total range: -0·1 to -1·065) [-1·371, -0·759], I2 = 85·1), positive (MBIs: 50 %, n = 6, g = -0·296 (total range: -0·155 to -0·416) [-0·528, -0·064], I2 = 34·69; ABIs: 33·33 %, n = 3, g = -0·602 (total range: -0·602 to 0·147) [-1·014, -0·191], I2 = 0), negative (MBIs: 100 %, n = 8, g = -0·94 (total range: -0·384 to -0.98) [-1·466, -0·413], I2 = 86·42; ABIs: 25 %, n = 2, g = -0·631 (total range: -0·028 to -0.631) [-1·108, -1·154], I2 = 0), affective symptoms (MBIs: 50 %, n = 9, g = -0·971 (total range: -0·275 to -0·971) [-1·413, -0·529], I2 = 91·32; ABIs: 33·33 %, n = 3, g = -0·854 (total range: -0·472 to -0·854) [-1·255, -0·453, I2 = 0), social functioning (MBIs: 100 %, n = 7, g = -1·368 (total range: -0·452 to -1·368) [-2·194, -0·542], I2 = 94·3; ABIs: g total range: -0·878 to 0·625), mindfulness (MBIs: 66·66 %, n = 5, g = -0·805 (total range: -0·488 to -1·429) [-1·16, -0·45], I2 = 0; ABIs: 66·66 %, n = 1, g = -0·959 (total range: -0·391 to -0·959) [-1·788, -0·129], I2 = NA), and acceptance (MBIs: g total range: -0·381 to 0·381; ABIs: 50 %, n = 4, g = -0·393 (total range: -0·393 to 0·398) [-0·673, -0·113], I2 = 0). Possible explanations for the differences in effect sizes for MBIs and ABIs are explored. Methodological assessments ranked 'low' or 'critically low' for all meta-analyses.

INTERPRETATION

Although subject to several limitations, significant small to large effect sizes were evident for overall symptomatology, mindfulness, and social functioning. Small to large effect sizes were found for positive, negative, and affective symptoms. Future research should incorporate additional risk of bias assessments, increased sample sizes, and consider cultural contexts (as the largest effect sizes were reported by studies with a majority of samples from Mainland China and Hong Kong) regarding the therapeutic benefits of MBIs/ABIs.

ROLE OF THE FUNDING SOURCE

There was no funding source for this study.

Autistic Traits and Psychosocial Predictors of Depressive Symptoms

Higher rates of depression and of depressed mood are associated with autistic traits, and both are associated with social interaction factors, such as social self-efficacy, social motivation and loneliness. This study examined whether these social factors explain the association between autistic traits and depression. 658 participants (527 women) completed an online survey with measures of autistic traits (AQ), social self-efficacy (Social Self-Efficacy Scale), social motivation (Social Striving Assessment Scale), loneliness (UCLA Loneliness Scale) and depressive symptoms (Beck Depression Inventory-II). A mediation analysis found the relationship between autistic traits and depressive symptoms was fully mediated by the other three factors (β[indirect] = .005, z = 2.63, p < .01; β[direct] = .05, z = 1.58, p > .05), forming a pathway from autistic traits, to social self-efficacy, to social motivation, to loneliness and finally to depressive symptoms. These results suggest that targeting social self-efficacy may break this pathway and disrupt this relationship. Interventions targeting supporting positive social interaction should be considered.

Imide-based enones: A new scaffold that inhibits biofilm formation in Gram-negative pathogens

We prepared a series of enones containing different substituents as potential antibiofilm molecules. The design considered the structural features previously found in N-acylhomoserine lactones, but it replaced the labile furanone with different imides portions. After evaluation, some of the analogs inhibited 50 % or more the formation of the biofilm from P. aeruginosa or A. baumannii; moreover, substituents attached at the phenyl ring, the size of the enone as well as the type of imide seemed relevant for the selectivity against the tested pathogens. In the end, we performed a molecular docking study using the crystallized LasR to describe the main interactions of the ligand-receptor complex and propose a plausible mechanism of action.

Air pollution and atherosclerosis

Air pollution is associated with considerable cardiovascular mortality and morbidity. The vascular disease atherosclerosis underlies many cardiovascular conditions, with atherosclerotic plaque rupture being a trigger for stroke and myocardial infarction. The acute and chronic effects of air pollution have the potential to exacerbate many different facets of atherosclerosis. This review provides an overview of how air pollution promotes the development of atherosclerosis. The review summaries the epidemiological evidence between exposure to air pollution and morphological measures of atherosclerosis such as carotid intimal media thickness, coronary artery calcification and aortic artery calcification, before summarising the biological mechanisms by which air pollution promotes atherosclerosis at the different stages of disease progression. We offer our perspective of the weight of evidence between air pollution to atherosclerosis and make recommendations for future research to advance this field. Given the ubiquity of air pollution exposure, we stress the need for urgency in efforts to tackle air pollution and emphasise the potential health gains from minimising the effects of air pollutants on this common and often fatal cardiovascular pathology.

Specialized Pro-Resolving Mediators as Emerging Players in Cardioprotection: From Inflammation Resolution to Therapeutic Potential

AIM

Timely myocardial reperfusion is essential for restoring blood flow to post-ischemic tissue, thereby reducing cardiac injury and limiting infarct size. However, this process can paradoxically result in additional, irreversible myocardial damage, known as myocardial ischemia-reperfusion injury (MIRI). The goal of this review is to explore the role of specialized pro-resolving mediators (SPMs) in atherosclerosis and MIRI, and to assess the therapeutic potential of targeting inflammation resolution in these cardiovascular conditions.

METHODS

This review summarizes current preclinical and clinical evidence on the involvement of SPMs in the pathogenesis of atherosclerosis and MIRI, acknowledging that several cellular and molecular aspects of their mechanisms of action remain to be fully elucidated.

RESULTS

MIRI is a complex phenomenon in which inflammation, initially triggered during ischemia and further amplified upon reperfusion, plays a central role in its pathogenesis. Various cellular and molecular players mediate the initial pro-inflammatory response and the subsequent anti-inflammatory reparative phase following acute myocardial infarction (AMI), contributing both to ischemia- and reperfusion-induced damage as well as to the healing process. SPMs have emerged as key endogenous immunoresolvents with potent anti-inflammatory, antioxidant, and pro-resolving properties that contribute to limit excessive acute inflammation and promote tissue repair. While dysregulated SPM-related signaling has been linked to various cardiovascular diseases (CVD), their precise role in AMI and MIRI remains incompletely understood.

CONCLUSION

Targeting inflammation resolution may represent a promising therapeutic strategy for mitigating atheroprogression and addressing a complex condition such as MIRI.

Calcitonin Gene-Related Peptide Levels in Children and Adolescents With Primary Headache Disorder

ObjectiveThis study aimed to investigate calcitonin gene-related peptide (CGRP) levels in children and adolescents with primary headache.MethodsAll patients underwent blood sampling regardless of their headache state (ictal or interictal) on the day of examination. The patients were grouped based on their headache diagnosis (migraine, tension-type headache, or mixed).ResultsNinety-two patients aged 5-18 years were included (29 diagnosed with migraine and 31 with tension-type headache). In the comparisons between the patients with migraine and the patients with tension-type headache, interictal CGRP levels in blood from the cubital vein showed no significant difference. Ictal samples were collected in the tension-type headache group only, and no significant difference was observed between the ictal and interictal phases. Variables such as headache diagnosis, sex, age, family history with primary headache, headache frequency, time since last headache, medication usage, and body mass index did not significantly influence CGRP levels.ConclusionNo significant difference in interictal CGRP levels between patients with migraine and patients with tension-type headache were found. In patients with tension-type headache, there were no significant differences between CGRP levels in the ictal and interictal state. We were not able to draw conclusions about differences in ictal levels of CGRP in patients with migraine compared with patients with tension-type headache, or in differences between ictal and interictal levels in patients with migraine. Future studies should aim to replicate these results in a larger study cohort.

Association and biological pathways between metabolic syndrome and incident Parkinson's disease: A prospective cohort study of 289,150 participants

The relationship between metabolic syndrome (MetS) and Parkinson's disease (PD) remains uncertain due to inconsistent findings in previous studies. This prospective cohort study investigated the association between MetS and PD risk, along with potential biological mechanisms, using data from 289,150 PD-free participants in the UK Biobank. MetS was defined by the presence of at least three of the following components, while preMetS included one or two: increased waist circumference, elevated triglycerides (TG), high blood pressure (BP), elevated HbA1c, or reduced high-density lipoprotein cholesterol (HDL-C). Cox proportional hazards models were utilized to assess the risk of PD, and mediation analyses explored the role of blood biomarkers. Over a median follow-up of 13.1 years, 1682 participants developed PD. PreMetS (HR: 1.24, 95 % CI: 1.02-1.51, P = 0.028) and MetS (HR: 1.32, 95 % CI: 1.08-1.61, P = 0.008) were associated with an increased PD risk, with Kaplan-Meier analysis showing risk escalation with more MetS components. Among individual MetS components, increased waist circumference, elevated HbA1c, and reduced HDL-C were significantly associated with higher PD risk, while elevated TG and BP showed no significant association. Mediation analysis indicated that biomarkers of liver function (alkaline phosphatase) and kidney function (cystatin C) partially mediated the MetS-PD relationship. These findings highlight a significant link between MetS and higher PD risk, with possible mediation through specific blood biomarkers, though temporal ambiguity warrants cautious interpretation.

Xiongshao Zhitong granules alleviate nitroglycerin-induced migraine by regulating the TRPV1-mediated NLRP3 inflammatory pathway in rats

BACKGROUND

Migraine is a prevalent neurological disorder accompanied by a considerable economic burden. Xiongshao Zhitong granules (XSZT) have anti-inflammatory and analgesic functions in the clinic and are used for migraine therapy. However, the mechanisms by which XSZT treats migraine remain unclear.

PURPOSE

To discover the underlying mechanism and active ingredients of XSZT in the treatment of migraine.

METHODS

The nitroglycerin (NTG)-induced chronic migraine (CM) model was established and used to detect the therapeutic effect of XSZT on migraine. To elucidate the mechanism, we detected transient receptor potential vanilloid 1 (TRPV1) -mediated NOD-like receptor protein 3 (NLRP3) inflammasome activation in the CM rat model and the LPS-induced inflammatory BV-2 cell model using Western blotting, immunofluorescence and ELISA techniques. The potentially active ingredients of XSZT were determined by UHPLC-LTQ-Orbitrap MS, molecular docking, and surface plasmon resonance.

RESULTS

Our findings revealed that XSZT reduced the number of head scratching, increased the periorbital pain threshold and shortened the time spent in the dark box, decreased c-Fos expression in the CM rat model, suggesting an analgesic effect of XSZT on migraine. XSZT inhibited neurogenic inflammation, including downregulating CGRP, TNF-α, IL-1β and IL-18 levels and decreasing the degranulation rate of mast cells. Additionally, XSZT suppressed the expression and activation of TRPV1 and the NLRP3 inflammasome in the trigeminal nucleus caudalis. In vitro experiments confirmed that activated TRPV1 increased the level of the NLRP3 inflammasome by increasing intracellular calcium levels. Galloylpaeoniflorin, isogastrin, ellagic acid and salvianolic acid A interacted with TRPV1 and inhibited IL-1β secretion.

CONCLUSION

XSZT plays a therapeutic role in migraine through regulating TRPV1-mediated NLRP3 inflammatory activation and galloylpaeoniflorin, isogastrin, ellagic acid and salvianolic acid A might be the active ingredients of XSZT, which provides an experimental basis for the clinical treatment of migraine.

The value of extra-diaphragmatic inspiratory muscle surface electromyography during postural control tasks in patients with chronic obstructive pulmonary disease

Concurrent dysfunctions in postural control and diaphragm are observed in patients with chronic obstructive pulmonary disease (COPD). Measuring diaphragm activation traditionally involves transesophageal diaphragm electromyography (EMGdi), which is costly and relatively invasive. Extra-diaphragmatic inspiratory muscle surface electromyography may serve as a useful physiological marker for EMGdi. This study compared EMGdi amplitude with surface EMG amplitude of other inspiratory muscles, including sternocleidomastoid (sEMGscm), scalene (sEMGscal), and parasternal intercostal muscles (sEMGic) during postural control tasks in nine patients with COPD (5 males; age: 65 ± 6 years; forced expiratory volume in the first second: 60 ± 27 % predicted). Simultaneous recordings of EMGdi, sEMGscm, sEMGscal, and sEMGic amplitudes were obtained during six postural control tasks involving upright standing with ballistic arm movements under different conditions of support surface (stable/foam), arm movement frequency (single/repetitive), and breathing modes (normal/breath-hold at end-expiration). EMG amplitudes were normalized to each muscle's maximum voluntary contraction. A linear mixed model with Bonferroni-Holm post-hoc tests and Bland-Altman analyses were performed. There was a significant EMG-by-task interaction (p = 0.0223). The amplitude of EMGdi was significantly lower than sEMGic across all tasks (p < 0.0001 to 0.0007), while no significant differences were observed between EMGdi and sEMGscm or EMGdi and sEMGscal after Bonferroni-Holm correction (p = 0.019-0.858). Bland-Altman analyses indicated reasonable agreement between EMGdi and both sEMGscm and sEMGscal (mean biases: 1.8 % and -3.7 %), while sEMGic had a significantly higher overall bias of -20.7 %. These findings suggest that both sEMGscal and sEMGscm can serve as useful physiological markers for EMGdi in postural control assessments in patients with COPD. NEW & NOTEWORTHY. This study highlights the potential of extra-diaphragmatic inspiratory muscle surface electromyography as a physiological marker for transesophageal diaphragm electromyography during postural control tasks in patients with COPD, thereby reducing the need for costly and invasive measurements.

Dosing Exercise to Regulate Cardiometabolic Risk Among People Requiring Cardiac Rehabilitation

Exercise is a crucial component of cardiac rehabilitation; however, lack of physical assessment and consideration of the full cardiovascular risk profile limits individualization and potentially effectiveness. We propose a model to prescribe exercise dose, dosing, and dosage that considers cardiorespiratory fitness, strength, blood pressure, glucose, and cholesterol concentrations, along with medications and nutrition to improve individual outcomes from cardiac rehabilitation.

Unravelling AMR dynamics in the rumenofaecobiome: Insights, challenges and implications for One Health

Antimicrobial resistance (AMR) is a critical global threat to human, animal and environmental health, exacerbated by horizontal gene transfer (HGT) via mobile genetic elements. This poses significant challenges that have a negative impact on the sustainability of the One Health approach, hindering its long-term viability and effectiveness in addressing the interconnectedness of global health. Recent studies on livestock animals, specifically ruminants, indicate that culturable ruminal bacteria harbour AMR genes with the potential for HGT. However, these studies have focused predominantly on using the faecobiome as a proxy to the rumen microbiome or using easily isolated and culturable bacteria, overlooking the unculturable population. These unculturable microbial groups could have a profound influence on the rumen resistome and AMR dynamics within livestock ecosystems, potentially holding critical insights for advanced understanding of AMR in One Health. In order to address this gap, this review of current research on the burden of AMR in livestock was undertaken, and it is proposed that combined study of the rumen microbiome and faecobiome, termed the 'rumenofaecobiome', should be performed to enhance understanding of the risks of AMR in ruminant livestock. This review discusses the complexities of the rumen microbiome and the risks of AMR transmission in this microbiome in a One Health context. AMR transmission dynamics and methodologies for assessing the risks of AMR in livestock are summarized, and future considerations for researching the impact of AMR in the rumen microbiome and the implications within the One Health framework are discussed.

Advanced nanoparticle engineering for precision therapeutics of brain diseases

Despite the increasing global prevalence of neurological disorders, the development of nanoparticle (NP) technologies for brain-targeted therapies confronts considerable challenges. One of the key obstacles in treating brain diseases is the blood-brain barrier (BBB), which restricts the penetration of NP-based therapies into the brain. To address this issue, NPs can be installed with specific ligands or bioengineered to boost their precision and efficacy in targeting brain-diseased cells by navigating across the BBB, ultimately improving patient treatment outcomes. At the outset of this review, we highlighted the critical role of ligand-functionalized or bioengineered NPs in treating brain diseases from a clinical perspective. We then identified the key obstacles and challenges NPs encounter during brain delivery, including immune clearance, capture by the reticuloendothelial system (RES), the BBB, and the complex post-BBB microenvironment. Following this, we overviewed the recent progress in NPs engineering, focusing on ligand-functionalization or bionic designs to enable active BBB transcytosis and targeted delivery to brain-diseased cells. Lastly, we summarized the critical challenges hindering clinical translation, including scalability issues and off-target effects, while outlining future opportunities for designing cutting-edge brain delivery technologies.

Biological mechanisms and immunotherapy of brain metastases in non-small cell lung cancer

Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related mortality worldwide, with Brain Metastases serving as a significant adverse prognostic factor. The blood-brain barrier poses a substantial challenge in the treatment of brain metastases, as it restricts the penetration of many anticancer agents. Novel immunotherapy, such as immune checkpoint inhibitors (ICIs) have emerged as promising treatment for NSCLC and its associated brain metastases. This review summarizes the biological mechanism underlying NSCLC brain metastases and provides an overview of the current landscape of immunotherapy, exploring the mechanism of action and clinical applications of these advanced treatments.

The Stroke Burden in China and Its Long-Term Trends: Insights from the Global Burden of Disease (GBD) Study 1990-2021

BACKGROUND AND AIM

To explore effective preventive strategies for stroke, it is of paramount importance to systematically assess its risk factors. Leveraging the Global Burden of Disease (GBD) data, this study aims to retrospectively analyze the long-term trends and epidemiological characteristics of stroke in China.

METHODS AND RESULTS

Drawing on the GBD 2021 data, this study conducted a comprehensive analysis of the burden of stroke in the Chinese population, encompassing prevalence, incidence, mortality, years of life lost (YLL), years lived with disability (YLDs), and disability-adjusted life years (DALYs). Subsequently, we examined the temporal trends of these indicators and employed a Joinpoint regression analysis coupled with an age-period-cohort (APC) model to precisely dissect mortality and incidence patterns. Furthermore, we delved into the attributable burden of stroke. The results indicated that the prevalence of stroke in China reached 26 million in 2021, representing a 104.26 % increase since 1990. Compared to 1990, the number of DALYs attributable to stroke increased by 45.25 %. Joinpoint analysis revealed a declining trend in incidence rates, while mortality rates showed a significant reduction. The APC model fitting outcomes suggested that prevalence rates were higher in recent generations than in the past, with an increase observed within the same age cohort. Notably, in 2019, the primary burden of cardiovascular diseases (CVDs) stemmed from metabolic risks, particularly hypertension, followed by air pollution particulate matter as an environmental risk factor.

CONCLUSIONS

Given China's vast population base and rapid aging process, the burden of stroke has emerged as a significant public health concern.

Impact of triglyceride glucose - Body mass index on depression risk in Chinese middle-aged and elderly adults: Evidence from a large-scale study

BACKGROUND

Current literature lacks evidence to characterize the relationship between the triglyceride glucose - body mass index (TyG-BMI) and depression. Therefore, this study aimed to elucidate the potential association between TyG-BMI and depression risk in a Chinese middle-aged and elderly population.

METHODS

The study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011, which included 17,708 participants. We used multifactorial logistic regression modeling to investigate the relationship between TyG-BMI and depression in Chinese adults, using smoothed curve fitting to assess the nonlinear relationship between them. In addition, we performed sensitivity and subgroup analyses to verify the robustness of the results.

RESULTS

A total of 9328 participants were included in our study, After adjusting for all potential covariates, participants with higher levels of TyG-BMI had a lower risk of depression compared to Q1, the adjusted OR (95 % CI) values were Q2 (OR: 0.84, 95 % CI: 0.74-0.96, p = 0.009), Q3 (OR: 0.75, 95 % CI: 0.65-0.86, p < 0.001), and Q4 (OR: 0.67, 95 % CI: 0.57-0.79, p < 0.001). The association between TyG-BMI and depression exhibited an L-shaped curve (nonlinear, p = 0.004). When TyG-BMI <200, Increased TyG-BMI was associated with a significantly lower risk of depression (OR = 0.87 [95 %CI:0.82-0.93], p < 0.001). However, there was no association between TyG-BMI and depression when TyG-BMI ≥200 (OR = 0.96 [95 %CI:0.91-1.02], p = 0.22).

CONCLUSION

The connection between TyG-BMI and depression in Chinese adults is L-shaped, with an inflection point around 200.

Biomarkers of aging: from molecules and surrogates to physiology and function

Many countries face an unprecedented challenge in aging demographics. This has led to an exponential growth in research on aging, which, coupled to a massive financial influx of funding in the private and public sectors, has resulted in seminal insights into the underpinnings of this biological process. However, critical validation in humans has been hampered by the limited translatability of results obtained in model organisms, additionally confined by the need for extremely time-consuming clinical studies in the ostensible absence of robust biomarkers that would allow monitoring in shorter time frames. In the future, molecular parameters might hold great promise in this regard. In contrast, biomarkers centered on function, resilience, and frailty are available at the present time, with proven predictive value for morbidity and mortality. In this review, the current knowledge of molecular and physiological aspects of human aging, potential antiaging strategies, and the basis, evidence, and potential application of physiological biomarkers in human aging are discussed.

Predicted plasma proteomics from genetic scores and treatment outcomes in major depression: a meta-analysis

Proteomics has been scarcely explored for predicting treatment outcomes in major depressive disorder (MDD), due to methodological challenges and costs. Predicting protein levels from genetic scores provides opportunities for exploratory studies and the selection of targeted panels. In this study, we examined the association between genetically predicted plasma proteins and treatment outcomes - including non-response, non-remission, and treatment-resistant depression (TRD) - in 3559 patients with MDD from four clinical samples. Protein levels were predicted from individual-level genotypes using genetic scores from the publicly available OmicsPred database, which estimated genetic scores based on genome-wide genotypes and proteomic measurements from the Olink and SomaScan platforms. Associations between predicted protein levels and treatment outcomes were assessed using logistic regression models, adjusted for potential confounders including population stratification. Results were meta-analysed using a random-effects model. The Bonferroni correction was applied. We analysed 257 proteins for Olink and 1502 for SomaScan; 111 proteins overlapped between the two platforms. Despite no association was significant after multiple-testing correction, many top results were consistent across phenotypes, in particular seven proteins were nominally associated with all the analysed outcomes (CHL1, DUSP13, EVA1C, FCRL2, KITLG, SMAP1, and TIM3/HAVCR2). Additionally, three proteins (CXCL6, IL5RA, and RARRES2) showed consistent nominal associations across both the Olink and SomaScan platforms. The convergence of results across phenotypes is in line with the hypothesis of the involvement of immune-inflammatory mechanisms and neuroplasticity in treatment response. These results can provide hints for guiding the selection of protein panels in future proteomic studies.

Bracing in Osteoarthritis

Bracing options for the therapeutic and preventative treatment of cartilage injury and osteoarthrosis have traditionally been understudied and underutilized due to poor patient compliance and a lack of published clinical efficacy data. However, recent advancements in 3-dimensional printing, biomechanical analysis of the joint, and dynamic joint unloading technologies are re-establishing bracing as an effective, low-cost, and low-risk non-surgical treatment option. When combined with other operative and non-operative methods in a data-based approach, bracing may offer improved outcomes in therapeutic, palliative, and prophylactic applications for cartilage disease and injury.

Chronic Musculoskeletal Pain and Central Sensitization-Related Symptoms in Chilean Victims of Political Violence During the 1973 to 1990 Dictatorship

People who suffer political violence (PV) are at risk of developing mental illness, chronic noncommunicable diseases, chronic pain, and decreased life expectancy. However, these indicators have been studied primarily in war veterans and refugees. The objective of this study was to estimate the prevalence of chronic musculoskeletal pain (CMP) and central sensitization-related symptoms (CSRS) in Chilean victims of PV during the 1973 to 1990 dictatorship. A cross-sectional observational multicenter study was conducted. Three hundred twenty-five people from six centers of a Ministry of Health of Chile program participated. The presence of CMP was determined by a history of pain ≥3 months, and CSRS was determined using the central sensitization inventory. About 69.23% of the sample had CMP (76.85% of females and 56.56% of males). About 60% of people with CMP showed a high level of CSRS severity (66.67% females and 44.93% males). Females presented significantly higher proportions of CMP (p < .001), and there was an association between CSRS severity and being female (p = .004). Chilean victims of PV during the 1973 to 1990 dictatorship presented a high prevalence of CMP and high-level CSRS severity. Both conditions affected females more than males. Future studies are needed to further delve into these variables' behavior and their influence on the quality of life in this population.