Background One of the major comorbidities in obese and morbidly obese patients is Type 2 diabetes (T2DM) with approximately 20% of them suffering from this disease. The objective of this review was to determine the ...Background One of the major comorbidities in obese and morbidly obese patients is Type 2 diabetes (T2DM) with approximately 20% of them suffering from this disease. The objective of this review was to determine the impact of Roux-en-Y gastric bypass (RYGB) surgery on the resolution rate of T2DM in obese diabetic patients.Methods A systematic review was made into the literature using MEDLINE database to search for relevant studies reporting the resolution or improvement of T2DM post RYGB. Data from the case series and systematic review were collected for different age groups and different degrees of obesity (obese,morbidly obese,super obese) and metaanalysed. The various other aspects of the surgery regarding the complications,mortality rate,cost analysis,improvement in quality of life were also reviewed. Results Data from 56 relevant studies were retrieved containing a total of 10289 patients. Metaanalysis of the data from case series and other systematic reviews showed that RYGB is an effective method for obtaining weight reduction in obese,morbidly obese patients and in elderly obese patients. The mean age of patients was 42.8 years,mean baseline BMI was 47.4 kg/m2.The mean percentage excess weight loss (%EWL) was 65.3% and mean change in BMI was 17.1 kg/m2.The mean resolution rate of diabetes was 76.4 % while the mean improved/resolved rate of T2DM was 87.4%. Conclusion RYGB is a highly effective method for patients of various degrees of obesity and different age groups for treatment of obesity and T2DM. It also appears to be an interesting option economically due to savings from diabetic medications which outweigh the costs of the surgery and follow-up coupled with increased quality of life.展开更多
Dear Editor,We read with a great interest the recently published systematic review by Shamsikhani and Hosseini titled,“Foot reflexology on nausea and vomiting:A systematic review.”[1]While the authors provided a com...Dear Editor,We read with a great interest the recently published systematic review by Shamsikhani and Hosseini titled,“Foot reflexology on nausea and vomiting:A systematic review.”[1]While the authors provided a comprehensive qualitative synthesis of six studies meeting their inclusion criteria,we believe that additional quantitative analysis would strengthen the evidence base for foot reflexology in managing nausea and vomiting.We conducted a complementary meta-analysis to provide quantitative evidence supporting the qualitative findings presented in the systematic review.展开更多
As a mathematical analysis method,fractal analysis can be used to quantitatively describe irregular shapes with self-similar or self-affine properties.Fractal analysis has been used to characterize the shapes of metal...As a mathematical analysis method,fractal analysis can be used to quantitatively describe irregular shapes with self-similar or self-affine properties.Fractal analysis has been used to characterize the shapes of metal materials at various scales and dimensions.Conventional methods make it difficult to quantitatively describe the relationship between the regular characteristics and properties of metal material surfaces and interfaces.However,fractal analysis can be used to quantitatively describe the shape characteristics of metal materials and to establish the quantitative relationships between the shape characteristics and various properties of metal materials.From the perspective of two-dimensional planes and three-dimensional curved surfaces,this paper reviews the current research status of the fractal analysis of metal precipitate interfaces,metal grain boundary interfaces,metal-deposited film surfaces,metal fracture surfaces,metal machined surfaces,and metal wear surfaces.The relationship between the fractal dimensions and properties of metal material surfaces and interfaces is summarized.Starting from three perspectives of fractal analysis,namely,research scope,image acquisition methods,and calculation methods,this paper identifies the direction of research on fractal analysis of metal material surfaces and interfaces that need to be developed.It is believed that revealing the deep influence mechanism between the fractal dimensions and properties of metal material surfaces and interfaces will be the key research direction of the fractal analysis of metal materials in the future.展开更多
To the editor:“A recent systematic review shows that the risk of death by suicide is 100 times higher in people living with HIV than in the general population”—World Health Organization,2022 The estimate that the r...To the editor:“A recent systematic review shows that the risk of death by suicide is 100 times higher in people living with HIV than in the general population”—World Health Organization,2022 The estimate that the risk of suicide is 100-fold higher in people with HIV(PWH)than in the general population is widely cited,including in the World Health Organization’s(WHO’s)World Mental Health report from which the above quote is taken.1 This figure originates from a systematic review and meta-analysis by Pelton and colleagues,who estimated the‘lifetime incidence’of suicide among PWH2 and directly compared this measure to the WHO’s annual global suicide mortality rate.展开更多
We highly commend Dr Souza et al.1for their systematic review research.The authors conducted a detailed investigation into the effects of ischemic preconditioning(IPC)on athletic performance,comparing it with placebo ...We highly commend Dr Souza et al.1for their systematic review research.The authors conducted a detailed investigation into the effects of ischemic preconditioning(IPC)on athletic performance,comparing it with placebo and no-intervention conditions.The study found that while IPC demonstrated superior effects over the no-intervention group in certain metrics(e.g.,time to exhaustion),its performance did not significantly surpass that of the placebo group.This suggests that the potential benefits of IPC may partially stem from participants’psychological expectations,or placebo effects.The study also highlighted the significant impact of placebo interventions on athletic performance,emphasizing the importance of distinguishing between placebo and no-intervention conditions in experimental designs.展开更多
BACKGROUND Upper gastrointestinal cancer(UGIC),including esophageal and gastric cancers,poses a major global health challenge due to its high morbidity and mortality.During the preoperative period,patients often face ...BACKGROUND Upper gastrointestinal cancer(UGIC),including esophageal and gastric cancers,poses a major global health challenge due to its high morbidity and mortality.During the preoperative period,patients often face functional decline,malnutrition,and psychological stress,which can impair recovery.Prehabilitation,a multidisciplinary preoperative intervention,shows promise in optimizing patients'physical and mental status.AIM To evaluate the impact of prehabilitation on patients undergoing UGIC surgery and provide a basis for implementation of the prehabilitation compound plan.METHODS A computerized search of databases including Web of Science,PubMed,EMBASE,The Cochrane Library,Cumulative Index to Nursing and Allied Health Literature,China National Knowledge Infrastructure,Wanfang,and Chinese Science and Technology Journal Database was used to collect clinical trials on the impact of prehabilitation on patients undergoing UGIC surgery.After screening,a meta-analysis was conducted using Review Manager 5.0 software,and linear regression analysis was performed on the prehabilitation duration and outcome indicators.RESULTS A total of 13 clinical trials were ultimately included,with 8 literature quality evaluations at A level and 5 literature quality evaluations at B level.The meta-analysis results showed that compared with conventional nursing,the prehabilitation group had higher six-minute walk distance,lower postoperative complications and mortality rates,and shorter hospital stays,with statistically significant differences;there were no statistically significant differences in intensive care unit monitoring time and albumin levels between the two groups;regression analysis between prehabilitation duration and outcome indicators showed no significant relationship.CONCLUSION Prehabilitation can improve the perioperative functional ability of patients with UGIC and promote postoperative recovery,but its impact on nutrition,psychology,and quality of life needs to be further explored through more high-quality trials;in addition,further research is needed on the prehabilitation time,location,and specific plan.展开更多
We sincerely thank the authors of the commentary1 for their thoughtful analysis and constructive critique of our systematic review on ischemic preconditioning(IPC)and placebo effects in exercise capacity and athletic ...We sincerely thank the authors of the commentary1 for their thoughtful analysis and constructive critique of our systematic review on ischemic preconditioning(IPC)and placebo effects in exercise capacity and athletic performance.2Their attention to methodological details,particularly concerning the inclusion and timing of warm-up protocols across studies,is commendable and contributes meaningfully to the ongoing refinement of IPC research in sports science.展开更多
The authors regret that the original publication of this paper did not include Jawad Fayaz as a co-author.After further discussions and a thorough review of the research contributions,it was agreed that his significan...The authors regret that the original publication of this paper did not include Jawad Fayaz as a co-author.After further discussions and a thorough review of the research contributions,it was agreed that his significant contributions to the foundational aspects of the research warranted recognition,and he has now been added as a co-author.展开更多
BACKGROUND The beneficial effects of sodium-glucose co-transporter-2 inhibitors(SGLT2i)on adverse cardiac outcomes in diabetic patients are well-established.However,the effects of SGLT2i against cancer therapy-related...BACKGROUND The beneficial effects of sodium-glucose co-transporter-2 inhibitors(SGLT2i)on adverse cardiac outcomes in diabetic patients are well-established.However,the effects of SGLT2i against cancer therapy-related cardiotoxicity remain understudied.We investigated the association between SGLT2i and cardiac outcomes in cancer patients.METHODS PubMed,Embase,and the Cochrane Library were searched from their inception until September 30,2024 for studies evaluating the effects of SGLT2i in patients with cancer.The primary outcomes included incident heart failure(HF),HF exacerbation,HF hospitalization,atrial fibrillation/atrial flutter(AF/AFL),myocardial infarction,and all-cause mortality.The secondary outcomes included acute kidney injury and sepsis.Odds ratio(OR)with 95%CI was pooled.RESULTS Thirteen studies with 85,596 patients were included.Compared to non-SGLT2i use,SGLT2i treatment was associated with lower risks of incident HF(OR=0.51,95%CI:0.32-0.79,P=0.003),HF exacerbation(OR=0.74,95%CI:0.63-0.87,P<0.001),AF/AFL(OR=0.67,95%CI:0.55-0.82,P<0.001),myocardial infarction(OR=0.61,95%CI:0.41-0.90,P=0.01),and all-cause mortality(OR=0.44,95%CI:0.28-0.69,P<0.001),but not for HF hospitalization(OR=0.58,95%CI:0.22-1.55,P=0.28).As for safety outcomes,SGLT2i use was associated with lower risks of acute kidney injury(OR=0.68,95%CI:0.57-0.81,P<0.001)and sepsis(OR=0.32,95%CI:0.23-0.44,P<0.001).CONCLUSIONS SGLT2i were associated with lower risks of incident HF,HF exacerbation,AF/AFL,myocardial infarction,allcause mortality,acute kidney injury,and sepsis in cancer patients.展开更多
BACKGROUND Cardiac resynchronization therapy(CRT)has been a major therapeutic advancement for patients with heart failure and electrical dyssynchrony.While CRT improves symptoms,reduces hospitalizations,and enhances s...BACKGROUND Cardiac resynchronization therapy(CRT)has been a major therapeutic advancement for patients with heart failure and electrical dyssynchrony.While CRT improves symptoms,reduces hospitalizations,and enhances survival,the role of implantable cardioverter-defibrillators(ICDs)alongside CRT in patients with non-ischemic cardiomyopathy(NICM)remains controversial.To evaluate and compare the outcomes of CRT with ICD(CRT-D)versus CRT with pacemaker-only(CRT-P)in individuals diagnosed with NICM,with a specific focus on the elderly.METHODS A comprehensive search of PubMed,Embase,and the Cochrane Central Register of Controlled Trials was conducted in January 2024.Studies comparing CRT-D and CRT-P in patients with NICM were included,with subgroup analyses focusing on patients aged 75 years and older.RESULTS Twelve studies,including two randomized clinical trials,with a total of 62,145 patients and 16,754 pooled death events(9,171 in CRT-D and 7,583 in CRT-P),were analyzed.CRT-D was associated with a significantly lower risk of all-cause mortality compared to CRT-P(pooled OR=0.72;95%CI:0.61-0.85;P<0.01),with significant heterogeneity(I2=83%).RCT subgroup analysis,was not statistically significant(pooled OR=0.82;95%CI:0.64-1.06;P=0.41;I2=0%).In patients older than 75 years,no significant difference in mortality risk was observed(pooled OR 0.96;95%CI:0.81-1.15;I2=39%).CONCLUSION Our meta-analysis suggests that the addition of ICD therapy to CRT in patients with NICM significantly reduces all-cause mortality.However,this benefit does not extend to cardiovascular mortality,likely due to the primary role of ICDs in preventing sudden cardiac death rather than other causes such as progressive heart failure.The survival advantage of CRT-D is most pronounced in younger patients,with those over 75 years of age deriving less benefit.This highlights the importance of careful patient selection,considering age and comorbidities,when deciding on ICD implantation in NICM patients.展开更多
Measuring cardiorespiratory fitness(CRF)is an important predictor of morbidity and mortality in epidemiological studies and clinical settings.1 However,the feasibility of measuring maximal CRF is low due to the time,e...Measuring cardiorespiratory fitness(CRF)is an important predictor of morbidity and mortality in epidemiological studies and clinical settings.1 However,the feasibility of measuring maximal CRF is low due to the time,equipment,and expertise needed to conduct laboratory cardiopulmonary exercise testing(CPET)to determine the maximal rate of oxygen uptake(VO2max)as an objective measure of CRF.Alternatively,indirect estimates of CRF have been applied by measuring maximal duration on treadmill or cycle ergometer tests,2,3 extrapolating maximal CRF from workload or heart rate during submaximal fitness tests,4,5 and using non-exercise algorithms to estimate CRF from an individual’s age,sex,body mass,and physical activity habits.6 It is assumed that objectively measured VO2max is superior to extrapolated and estimated values due to errors associated with the estimated values;7,8 however,until Singh et al.9 newly released article in the Journal of Sport and Health Science,the comparability of these methods in identifying risks for all-cause and cardiovascular disease(CVD)mortality was unknown.展开更多
Temperature plays a crucial role in shaping microbial ecosystems during anaerobic digestion.However,the specific microbial communities and their functions across a wide temperature range still remain elusive.This stud...Temperature plays a crucial role in shaping microbial ecosystems during anaerobic digestion.However,the specific microbial communities and their functions across a wide temperature range still remain elusive.This study employed a genome-centric metagenomic approach to explore microbial metabolic pathways and synergistic networks at temperatures of 35,44,53,55,and 65℃.A total of 84 metagenome assembled genomes(MAGs)were assembled,with over 65%of these MAGs corresponding to novel bacterial and archaeal species(including Firmicutes,Chloroflexota,Bacteroidia and Methanobacteriota),greatly enhancing our current comprehension anaerobic digestion process.Notably,functional annotation identified that 44_bin.2(Methanothrix_A sp.001602645)harbors enzymes associated with hydrogenotrophic metabolism.Additionally,this microorganism exhibited diverse metabolic capabilities at 44℃,a temperature commonly employed in industrial practice yet less explored in bench studies.Consequently,it implies a promising potential for conducting anaerobic digestion at a moderate thermophilic temperature,as opposed to the conventional mesophilic range.The microorganism exhibited a variety of metabolic capabilities at 44℃,a temperature frequently employed in industrial applications but underexplored in laboratory investigations.The findings suggest that anaerobic digestion carried out at moderate thermophilic temperatures may have a higher potential for methane production.展开更多
BACKGROUND Depression is a widespread psychological disorder that has substantial effects on public health and society.Conventional therapies include medication and psycho-therapy,recent investigations have highlighte...BACKGROUND Depression is a widespread psychological disorder that has substantial effects on public health and society.Conventional therapies include medication and psycho-therapy,recent investigations have highlighted the possible advantages of multi-modal treatments,such as physical therapy,for improving depression.AIM To perform a meta-analysis of how multimodal physical therapy can help treat depression.METHODS We searched for collection of articles that satisfied the inclusion and exclusion criteria,encompassing randomized controlled research-related sources.We incorporated these studies into the meta-analysis using terms such as“findings”,“intervention”,and“population attributes”.We used statistical examination to measure the total impact magnitude and evaluate study variability.RESULTS The encouraging aspect is that multi-modal physical therapy is being considered for its effectiveness in treating symptoms related to depression.Sensitivity analysis was conducted to identify key factors and determine their impact on quality.CONCLUSION Regarding treatment for depression,this meta-analysis extends the increasing number of studies demonstrating the effectiveness of multimodal physical therapy.展开更多
BACKGROUND Meta-analysis is a critical tool in evidence-based medicine,particularly in cardiology,where it synthesizes data from multiple studies to inform clinical decisions.This study explored the potential of using...BACKGROUND Meta-analysis is a critical tool in evidence-based medicine,particularly in cardiology,where it synthesizes data from multiple studies to inform clinical decisions.This study explored the potential of using ChatGPT to streamline and enhance the meta-analysis process.AIM To investigate the potential of ChatGPT to conduct meta-analyses in interventional cardiology by comparing the results of ChatGPT-generated analyses with those of randomly selected,human-conducted meta-analyses on the same topic.METHODS We systematically searched PubMed for meta-analyses on interventional cardiology published in 2024.Five metaanalyses were randomly chosen.ChatGPT 4.0 was used to perform meta-analyses on the extracted data.We compared the results from ChatGPT with the original meta-analyses,focusing on key effect sizes,such as risk ratios(RR),hazard ratios,and odds ratios,along with their confidence intervals(CI)and P values.RESULTS The ChatGPT results showed high concordance with those of the original meta-analyses.For most outcomes,the effect measures and P values generated by ChatGPT closely matched those of the original studies,except for the RR of stent thrombosis in the Sreenivasan et al study,where ChatGPT reported a non-significant effect size,while the original study found it to be statistically significant.While minor discrepancies were observed in specific CI and P values,these differences did not alter the overall conclusions drawn from the analyses.CONCLUSION Our findings suggest the potential of ChatGPT in conducting meta-analyses in interventional cardiology.However,further research is needed to address the limitations of transparency and potential data quality issues,ensuring that AI-generated analyses are robust and trustworthy for clinical decision-making.展开更多
Coconut(Cocos nucifera L.)is a key tropical economic tree valued for its fruit flavor,particularly 2-acetyl-1-pyrroline(2AP),a vital aroma metabolite.To enhance high-aromatic coconut breeding efforts,it is essential t...Coconut(Cocos nucifera L.)is a key tropical economic tree valued for its fruit flavor,particularly 2-acetyl-1-pyrroline(2AP),a vital aroma metabolite.To enhance high-aromatic coconut breeding efforts,it is essential to deeply understand the hereditary factors governing the production of 2AP.In this study,a genome-wide association analysis identifies 32 loci that exhibit significant associations with 2AP content based on single nucleotide polymorphism(SNP)variations from 168 aromatic coconut germplasm resources.Transcriptome analysis then pinpoints 22 candidate genes near significant loci involved in 2AP metabolism.Proteins encoded by these genes are involved in amino acid metabolism,glycolysis,and secondary metabolism.Among these,Asparagine synthetase coding gene ASN1,Gamma-glutamylcysteine synthetase coding gene GSH1,and UbiA prenyltransferase coding gene UBIA are enriched in the linkage region constructed by significant locus Chr04_61490504.In particular,the SNP mutation of CnASN1 leads to amino acid changes in the functional region of the coding protein,potentially resulting in differences in 2AP content among haplotype populations.Identifying variations in related candidate genes,particularly the gene CnASN1,provides molecular markers closely associated with 2AP synthesis for coconut breeding and offers further insights into the metabolic mechanisms of 2AP.展开更多
It is of critical importance to determine the endpoint of stabilization for landfills that are stabilized by aeration acceleration.Current stabilization evaluation methods are inconsistent and mostly fail to account f...It is of critical importance to determine the endpoint of stabilization for landfills that are stabilized by aeration acceleration.Current stabilization evaluation methods are inconsistent and mostly fail to account for the effect of oxygen concentration.In this study,degradation experiments were conducted to quantitatively analyze the impact of oxygen on microbial communities and metabolic functions.High-throughput sequencing analysis demonstrated that an oxygen concentration exceeding 10%significantly enhances amino acid metabolism,secondary metabolite biosynthesis,and exogenous biodegradation.Three-dimensional fluorescence data were analyzed using the PARAFAC method,and a novel fluorescence-based stabilization indicator was proposed based on the ratio of fulvic-like to tyrosine-like substances.When the growth multiples of the fluorescence index exceed 10-fold,it can be inferred that degradation has been met the stabilization endpoint.Principal component analysis was employed to establish multiple regression equations between the physicochemical parameters of landfill waste and dissolved fluorescent substants,offering an innovative insight to evaluate the stabilization process of aerated landfills.展开更多
The predominant causal agent of poplar leaf blight is the pathogenic fungus Alternaria alternata (Fr.) Keissl., which exhibits host specificity toward Populus species. To elucidate the molecular response mechanisms of...The predominant causal agent of poplar leaf blight is the pathogenic fungus Alternaria alternata (Fr.) Keissl., which exhibits host specificity toward Populus species. To elucidate the molecular response mechanisms of A. alternata under fludioxonil fungicide stress, the fungus was cultured at the half-maximal effective concentration (EC₅₀) of fludioxonil. Transcriptomic and metabolomic profiles were analyzed using mycelia harvested under these conditions. Comparative analysis revealed 1,001 differentially expressed genes (DEGs) in the resistant strain (RS) relative to the wild-type strain (WT), comprising 628 upregulated and 373 downregulated genes. Concurrently, 524 differentially accumulated metabolites (DAMs) were identified, with 336 upregulated and 188 downregulated metabolites. KEGG pathway enrichment demonstrated pronounced upregulation in glycerophospholipid metabolism, α-linolenic acid metabolism, nucleic acid biosynthesis, and glycosylation processes. Conversely, arachidonic acid and galactose metabolism pathways were suppressed. Significant downregulation was observed in phosphatidylinositol signaling, aflatoxin biosynthesis, and cutin/suberin/wax biosynthesis pathways. Transcriptomic profiling further indicated that upregulated DEGs were predominantly associated with amino sugar/nucleotide sugar metabolism, ABC transporters, aflatoxin biosynthesis, and purine metabolism, while downregulated DEGs were enriched in N-glycan biosynthesis, endoplasmic reticulum protein processing, steroid biosynthesis, and riboflavin metabolism. Fludioxonil exerted substantial inhibitory effects on fungal growth, pathogenicity, and metabolic activity. Mechanistically, A. alternata counteracted fungicide-induced stress through modulation of its antioxidant defense system. This integrative multi-omics study delineates the dynamic gene expression and metabolic reprogramming in A. alternata under fludioxonil exposure, providing novel insights into potential molecular targets and informing the development of next-generation fungicidal strategies for phytopathogen control.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is among the most aggressive primary liver cancers,leading to significant global mortality.While early diagnosis improves prognosis,treatment decisions,particularly between surg...BACKGROUND Hepatocellular carcinoma(HCC)is among the most aggressive primary liver cancers,leading to significant global mortality.While early diagnosis improves prognosis,treatment decisions,particularly between surgical resection and radiofrequency ablation(RFA),remain controversial.AIM To clarify this issue using sentiment analysis of medical literature alongside a meta-analysis of overall survival(OS).METHODS We included studies comparing liver resection and RFA,excluding case reports,editorials,and studies without relevant outcomes.A systematic search in PubMed and Web of Science identified 197 studies.Abstracts underwent sentiment analysis using Python’s Natural Language Toolkit library,categorizing them as favoring resection,ablation,or neutral.We also performed a meta-analysis using a random-effects model on 11 studies reporting hazard ratios(HRs)for OS.RESULTS Sentiment analysis revealed that 75.1%of abstracts were neutral,14.2%favored resection,and 10.7%favored RFA.The meta-analysis showed a significant survival advantage for liver resection,with a pooled HR of 0.5924(95%confidence interval:0.540-0.649).Heterogeneity was moderate(I²=39.98%).Despite the meta-analysis demonstrating clear survival benefits of liver resection,most abstracts maintained a neutral stance.This discrepancy highlights potential biases or hesitancy in drawing definitive conclusions.CONCLUSION The study emphasizes the need for clinicians to prioritize robust statistical evidence over narrative impressions.Liver resection remains the preferred treatment for HCC in eligible patients.展开更多
[Objectives]To evaluate the impact of nasal insulin administration on postoperative delirium(POD)through meta-analysis.[Methods]The Cochrane Library,PubMed,Embase,Web of Science,China National Knowledge Infrastructure...[Objectives]To evaluate the impact of nasal insulin administration on postoperative delirium(POD)through meta-analysis.[Methods]The Cochrane Library,PubMed,Embase,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang Database,and China Science and Technology Journal Database(CSTJ)were systematically searched for relevant literature published prior to February 27,2025.Literature screening and data extraction were conducted by two independent researchers in accordance with predetermined inclusion and exclusion criteria.The primary observation indicator was the incidence of POD across various treatment populations.The risk ratio for the primary outcome was calculated using the Mantel-Haenszel method.The secondary outcomes included the adverse effects associated with insulin treatment,which encompassed the glycemic variability indices,the incidence of nasal irritation symptoms following administration,hypoglycemic reactions,and insulin allergic reactions.The study protocol was registered on PROSPERO(CRD420250607492)before data extraction.[Results]A total of five randomized controlled trials involving 357 patients were included in the analysis.In the adult population undergoing surgical procedures,the administration of insulin via nasal delivery was found to significantly reduce the incidence of POD[RR=0.35,95%CI(0.23-0.53),P<0.001].The results of the subgroup analysis indicated that there were notable differences in the effectiveness of various doses of insulin administered nasally in preventing POD.Specifically,both the 20 U dose group[RR=0.45,95%CI:(0.29,0.70),P<0.001]and the 30 U dose group[RR=0.01,95%CI:(0.03,0.42),P<0.001]showed a significantly lower incidence of POD compared to the control group,with statistically significant conclusions.Conversely,the 40 U dose group[RR=0.47,95%CI:(0.17,1.34),P=0.16]yielded no statistically significant difference.Furthermore,the efficacy in preventing POD was found to be greater in the 30 U dose group compared to the 20 U dose group.Additionally,two cases of hypoglycemic reactions and increased nasal irritation symptom scores were reported in the 40 U dose group across the entire study population(P<0.05),suggesting potential adverse risks associated with this dosage.[Conclusions]The nasal administration of insulin significantly decreases the incidence of POD at a specific dosage,with optimal efficacy and high safety observed at a dosage of 30 U.展开更多
Alzheimer’s dementia(AD)and type 2 diabetes(T2D)are interrelated global public health problems,and the current epidemics of both AD and T2D are insulin resistance diseases.Thus,AD and T2D may share common risk factor...Alzheimer’s dementia(AD)and type 2 diabetes(T2D)are interrelated global public health problems,and the current epidemics of both AD and T2D are insulin resistance diseases.Thus,AD and T2D may share common risk factors such as an unhealthy diet,lifestyle,and obesity.Meat products is an important part of the diet of consumers worldwide.This systematic review and meta-analysis aims to assess and estimate the effect of meat products consumption on AD and T2D in humans.Web of Science,MEDLINE,PubMed,Cochrane Library,and Embase were searched from January 2012 to April 2024.29 articles reported 32 cohort studies with 1785769 subjects,with 3546 AD cases and 91092 T2D cases that met the inclusion criteria and were included in our analysis.Consumption of various meat products increased the risk of T2D(hazard ratios(HR)=1.19,95%confidence intervals(CI):1.13−1.26,P=0.000;I2=88.5%),consumption of smoked,grilled/roasted and fried meat products was more likely to induce T2D(HR=1.24,95%CI:1.18−1.30,P=0.000;I2=76.1%),but was borderline significant for the risk of AD(HR=1.11,95%CI:0.98−1.25,P=0.094;I2=58.8%),with consumption of mainly livestock and poultry products increasing the risk(HR=1.21,95%CI:1.03−1.42,P=0.017;I2=66.8%).The association between meat products consumption and AD risk was influenced by meat type and sample size,while the risk of T2D was influenced by meat type,follow-up and sex.A daily intake of 27,123 and 170 g of livestock products increased the risk of T2D by 10%,51%and 70%respectively,whereas the risk of T2D was reduced when the intake of various meat products was less than 23 g/day.展开更多
文摘Background One of the major comorbidities in obese and morbidly obese patients is Type 2 diabetes (T2DM) with approximately 20% of them suffering from this disease. The objective of this review was to determine the impact of Roux-en-Y gastric bypass (RYGB) surgery on the resolution rate of T2DM in obese diabetic patients.Methods A systematic review was made into the literature using MEDLINE database to search for relevant studies reporting the resolution or improvement of T2DM post RYGB. Data from the case series and systematic review were collected for different age groups and different degrees of obesity (obese,morbidly obese,super obese) and metaanalysed. The various other aspects of the surgery regarding the complications,mortality rate,cost analysis,improvement in quality of life were also reviewed. Results Data from 56 relevant studies were retrieved containing a total of 10289 patients. Metaanalysis of the data from case series and other systematic reviews showed that RYGB is an effective method for obtaining weight reduction in obese,morbidly obese patients and in elderly obese patients. The mean age of patients was 42.8 years,mean baseline BMI was 47.4 kg/m2.The mean percentage excess weight loss (%EWL) was 65.3% and mean change in BMI was 17.1 kg/m2.The mean resolution rate of diabetes was 76.4 % while the mean improved/resolved rate of T2DM was 87.4%. Conclusion RYGB is a highly effective method for patients of various degrees of obesity and different age groups for treatment of obesity and T2DM. It also appears to be an interesting option economically due to savings from diabetic medications which outweigh the costs of the surgery and follow-up coupled with increased quality of life.
文摘Dear Editor,We read with a great interest the recently published systematic review by Shamsikhani and Hosseini titled,“Foot reflexology on nausea and vomiting:A systematic review.”[1]While the authors provided a comprehensive qualitative synthesis of six studies meeting their inclusion criteria,we believe that additional quantitative analysis would strengthen the evidence base for foot reflexology in managing nausea and vomiting.We conducted a complementary meta-analysis to provide quantitative evidence supporting the qualitative findings presented in the systematic review.
基金financially supported by the National Key R&D Program of China(No.2022YFE0121300)the National Natural Science Foundation of China(No.52374376)the Introduction Plan for High-end Foreign Experts(No.G2023105001L)。
文摘As a mathematical analysis method,fractal analysis can be used to quantitatively describe irregular shapes with self-similar or self-affine properties.Fractal analysis has been used to characterize the shapes of metal materials at various scales and dimensions.Conventional methods make it difficult to quantitatively describe the relationship between the regular characteristics and properties of metal material surfaces and interfaces.However,fractal analysis can be used to quantitatively describe the shape characteristics of metal materials and to establish the quantitative relationships between the shape characteristics and various properties of metal materials.From the perspective of two-dimensional planes and three-dimensional curved surfaces,this paper reviews the current research status of the fractal analysis of metal precipitate interfaces,metal grain boundary interfaces,metal-deposited film surfaces,metal fracture surfaces,metal machined surfaces,and metal wear surfaces.The relationship between the fractal dimensions and properties of metal material surfaces and interfaces is summarized.Starting from three perspectives of fractal analysis,namely,research scope,image acquisition methods,and calculation methods,this paper identifies the direction of research on fractal analysis of metal material surfaces and interfaces that need to be developed.It is believed that revealing the deep influence mechanism between the fractal dimensions and properties of metal material surfaces and interfaces will be the key research direction of the fractal analysis of metal materials in the future.
基金supported by the Swiss National Science Foundation(grant numbers 193381 and 189498)the US National Institutes of Health(the National Institute of Allergy and Infectious Diseases,the Eunice Kennedy Shriver National Institute of Child Health and Human Development,the National Cancer Institute,the National Institute of Mental Health,the National Institute on Drug Abuse,the National Heart,Lung,and Blood Institute,the National Institute on Alcohol Abuse and Alcoholism,the National Institute of Diabetes and Digestive and Kidney Diseases and the Fogarty International Center)(grant numbers U01AI069924 and 1K43TW012840-01).
文摘To the editor:“A recent systematic review shows that the risk of death by suicide is 100 times higher in people living with HIV than in the general population”—World Health Organization,2022 The estimate that the risk of suicide is 100-fold higher in people with HIV(PWH)than in the general population is widely cited,including in the World Health Organization’s(WHO’s)World Mental Health report from which the above quote is taken.1 This figure originates from a systematic review and meta-analysis by Pelton and colleagues,who estimated the‘lifetime incidence’of suicide among PWH2 and directly compared this measure to the WHO’s annual global suicide mortality rate.
文摘We highly commend Dr Souza et al.1for their systematic review research.The authors conducted a detailed investigation into the effects of ischemic preconditioning(IPC)on athletic performance,comparing it with placebo and no-intervention conditions.The study found that while IPC demonstrated superior effects over the no-intervention group in certain metrics(e.g.,time to exhaustion),its performance did not significantly surpass that of the placebo group.This suggests that the potential benefits of IPC may partially stem from participants’psychological expectations,or placebo effects.The study also highlighted the significant impact of placebo interventions on athletic performance,emphasizing the importance of distinguishing between placebo and no-intervention conditions in experimental designs.
基金Supported by Key Project of Jiangsu Provincial Health(ZD2022052).
文摘BACKGROUND Upper gastrointestinal cancer(UGIC),including esophageal and gastric cancers,poses a major global health challenge due to its high morbidity and mortality.During the preoperative period,patients often face functional decline,malnutrition,and psychological stress,which can impair recovery.Prehabilitation,a multidisciplinary preoperative intervention,shows promise in optimizing patients'physical and mental status.AIM To evaluate the impact of prehabilitation on patients undergoing UGIC surgery and provide a basis for implementation of the prehabilitation compound plan.METHODS A computerized search of databases including Web of Science,PubMed,EMBASE,The Cochrane Library,Cumulative Index to Nursing and Allied Health Literature,China National Knowledge Infrastructure,Wanfang,and Chinese Science and Technology Journal Database was used to collect clinical trials on the impact of prehabilitation on patients undergoing UGIC surgery.After screening,a meta-analysis was conducted using Review Manager 5.0 software,and linear regression analysis was performed on the prehabilitation duration and outcome indicators.RESULTS A total of 13 clinical trials were ultimately included,with 8 literature quality evaluations at A level and 5 literature quality evaluations at B level.The meta-analysis results showed that compared with conventional nursing,the prehabilitation group had higher six-minute walk distance,lower postoperative complications and mortality rates,and shorter hospital stays,with statistically significant differences;there were no statistically significant differences in intensive care unit monitoring time and albumin levels between the two groups;regression analysis between prehabilitation duration and outcome indicators showed no significant relationship.CONCLUSION Prehabilitation can improve the perioperative functional ability of patients with UGIC and promote postoperative recovery,but its impact on nutrition,psychology,and quality of life needs to be further explored through more high-quality trials;in addition,further research is needed on the prehabilitation time,location,and specific plan.
文摘We sincerely thank the authors of the commentary1 for their thoughtful analysis and constructive critique of our systematic review on ischemic preconditioning(IPC)and placebo effects in exercise capacity and athletic performance.2Their attention to methodological details,particularly concerning the inclusion and timing of warm-up protocols across studies,is commendable and contributes meaningfully to the ongoing refinement of IPC research in sports science.
文摘The authors regret that the original publication of this paper did not include Jawad Fayaz as a co-author.After further discussions and a thorough review of the research contributions,it was agreed that his significant contributions to the foundational aspects of the research warranted recognition,and he has now been added as a co-author.
基金supported by the National Natural Science Foundation of China(No.82170327&No.82370332)the Tianjin Key Medical Discipline(Specialty)Construction Project(TJYXZDXK-029A).
文摘BACKGROUND The beneficial effects of sodium-glucose co-transporter-2 inhibitors(SGLT2i)on adverse cardiac outcomes in diabetic patients are well-established.However,the effects of SGLT2i against cancer therapy-related cardiotoxicity remain understudied.We investigated the association between SGLT2i and cardiac outcomes in cancer patients.METHODS PubMed,Embase,and the Cochrane Library were searched from their inception until September 30,2024 for studies evaluating the effects of SGLT2i in patients with cancer.The primary outcomes included incident heart failure(HF),HF exacerbation,HF hospitalization,atrial fibrillation/atrial flutter(AF/AFL),myocardial infarction,and all-cause mortality.The secondary outcomes included acute kidney injury and sepsis.Odds ratio(OR)with 95%CI was pooled.RESULTS Thirteen studies with 85,596 patients were included.Compared to non-SGLT2i use,SGLT2i treatment was associated with lower risks of incident HF(OR=0.51,95%CI:0.32-0.79,P=0.003),HF exacerbation(OR=0.74,95%CI:0.63-0.87,P<0.001),AF/AFL(OR=0.67,95%CI:0.55-0.82,P<0.001),myocardial infarction(OR=0.61,95%CI:0.41-0.90,P=0.01),and all-cause mortality(OR=0.44,95%CI:0.28-0.69,P<0.001),but not for HF hospitalization(OR=0.58,95%CI:0.22-1.55,P=0.28).As for safety outcomes,SGLT2i use was associated with lower risks of acute kidney injury(OR=0.68,95%CI:0.57-0.81,P<0.001)and sepsis(OR=0.32,95%CI:0.23-0.44,P<0.001).CONCLUSIONS SGLT2i were associated with lower risks of incident HF,HF exacerbation,AF/AFL,myocardial infarction,allcause mortality,acute kidney injury,and sepsis in cancer patients.
文摘BACKGROUND Cardiac resynchronization therapy(CRT)has been a major therapeutic advancement for patients with heart failure and electrical dyssynchrony.While CRT improves symptoms,reduces hospitalizations,and enhances survival,the role of implantable cardioverter-defibrillators(ICDs)alongside CRT in patients with non-ischemic cardiomyopathy(NICM)remains controversial.To evaluate and compare the outcomes of CRT with ICD(CRT-D)versus CRT with pacemaker-only(CRT-P)in individuals diagnosed with NICM,with a specific focus on the elderly.METHODS A comprehensive search of PubMed,Embase,and the Cochrane Central Register of Controlled Trials was conducted in January 2024.Studies comparing CRT-D and CRT-P in patients with NICM were included,with subgroup analyses focusing on patients aged 75 years and older.RESULTS Twelve studies,including two randomized clinical trials,with a total of 62,145 patients and 16,754 pooled death events(9,171 in CRT-D and 7,583 in CRT-P),were analyzed.CRT-D was associated with a significantly lower risk of all-cause mortality compared to CRT-P(pooled OR=0.72;95%CI:0.61-0.85;P<0.01),with significant heterogeneity(I2=83%).RCT subgroup analysis,was not statistically significant(pooled OR=0.82;95%CI:0.64-1.06;P=0.41;I2=0%).In patients older than 75 years,no significant difference in mortality risk was observed(pooled OR 0.96;95%CI:0.81-1.15;I2=39%).CONCLUSION Our meta-analysis suggests that the addition of ICD therapy to CRT in patients with NICM significantly reduces all-cause mortality.However,this benefit does not extend to cardiovascular mortality,likely due to the primary role of ICDs in preventing sudden cardiac death rather than other causes such as progressive heart failure.The survival advantage of CRT-D is most pronounced in younger patients,with those over 75 years of age deriving less benefit.This highlights the importance of careful patient selection,considering age and comorbidities,when deciding on ICD implantation in NICM patients.
文摘Measuring cardiorespiratory fitness(CRF)is an important predictor of morbidity and mortality in epidemiological studies and clinical settings.1 However,the feasibility of measuring maximal CRF is low due to the time,equipment,and expertise needed to conduct laboratory cardiopulmonary exercise testing(CPET)to determine the maximal rate of oxygen uptake(VO2max)as an objective measure of CRF.Alternatively,indirect estimates of CRF have been applied by measuring maximal duration on treadmill or cycle ergometer tests,2,3 extrapolating maximal CRF from workload or heart rate during submaximal fitness tests,4,5 and using non-exercise algorithms to estimate CRF from an individual’s age,sex,body mass,and physical activity habits.6 It is assumed that objectively measured VO2max is superior to extrapolated and estimated values due to errors associated with the estimated values;7,8 however,until Singh et al.9 newly released article in the Journal of Sport and Health Science,the comparability of these methods in identifying risks for all-cause and cardiovascular disease(CVD)mortality was unknown.
基金supported by the National Natural Science Foundation of China(No.52270138)。
文摘Temperature plays a crucial role in shaping microbial ecosystems during anaerobic digestion.However,the specific microbial communities and their functions across a wide temperature range still remain elusive.This study employed a genome-centric metagenomic approach to explore microbial metabolic pathways and synergistic networks at temperatures of 35,44,53,55,and 65℃.A total of 84 metagenome assembled genomes(MAGs)were assembled,with over 65%of these MAGs corresponding to novel bacterial and archaeal species(including Firmicutes,Chloroflexota,Bacteroidia and Methanobacteriota),greatly enhancing our current comprehension anaerobic digestion process.Notably,functional annotation identified that 44_bin.2(Methanothrix_A sp.001602645)harbors enzymes associated with hydrogenotrophic metabolism.Additionally,this microorganism exhibited diverse metabolic capabilities at 44℃,a temperature commonly employed in industrial practice yet less explored in bench studies.Consequently,it implies a promising potential for conducting anaerobic digestion at a moderate thermophilic temperature,as opposed to the conventional mesophilic range.The microorganism exhibited a variety of metabolic capabilities at 44℃,a temperature frequently employed in industrial applications but underexplored in laboratory investigations.The findings suggest that anaerobic digestion carried out at moderate thermophilic temperatures may have a higher potential for methane production.
基金Supported by Pharmaceutical Science and Technology Project in Zhejiang Province,No.2023RC266Natural Science Foundation of Ningbo,No.202003N4266.
文摘BACKGROUND Depression is a widespread psychological disorder that has substantial effects on public health and society.Conventional therapies include medication and psycho-therapy,recent investigations have highlighted the possible advantages of multi-modal treatments,such as physical therapy,for improving depression.AIM To perform a meta-analysis of how multimodal physical therapy can help treat depression.METHODS We searched for collection of articles that satisfied the inclusion and exclusion criteria,encompassing randomized controlled research-related sources.We incorporated these studies into the meta-analysis using terms such as“findings”,“intervention”,and“population attributes”.We used statistical examination to measure the total impact magnitude and evaluate study variability.RESULTS The encouraging aspect is that multi-modal physical therapy is being considered for its effectiveness in treating symptoms related to depression.Sensitivity analysis was conducted to identify key factors and determine their impact on quality.CONCLUSION Regarding treatment for depression,this meta-analysis extends the increasing number of studies demonstrating the effectiveness of multimodal physical therapy.
文摘BACKGROUND Meta-analysis is a critical tool in evidence-based medicine,particularly in cardiology,where it synthesizes data from multiple studies to inform clinical decisions.This study explored the potential of using ChatGPT to streamline and enhance the meta-analysis process.AIM To investigate the potential of ChatGPT to conduct meta-analyses in interventional cardiology by comparing the results of ChatGPT-generated analyses with those of randomly selected,human-conducted meta-analyses on the same topic.METHODS We systematically searched PubMed for meta-analyses on interventional cardiology published in 2024.Five metaanalyses were randomly chosen.ChatGPT 4.0 was used to perform meta-analyses on the extracted data.We compared the results from ChatGPT with the original meta-analyses,focusing on key effect sizes,such as risk ratios(RR),hazard ratios,and odds ratios,along with their confidence intervals(CI)and P values.RESULTS The ChatGPT results showed high concordance with those of the original meta-analyses.For most outcomes,the effect measures and P values generated by ChatGPT closely matched those of the original studies,except for the RR of stent thrombosis in the Sreenivasan et al study,where ChatGPT reported a non-significant effect size,while the original study found it to be statistically significant.While minor discrepancies were observed in specific CI and P values,these differences did not alter the overall conclusions drawn from the analyses.CONCLUSION Our findings suggest the potential of ChatGPT in conducting meta-analyses in interventional cardiology.However,further research is needed to address the limitations of transparency and potential data quality issues,ensuring that AI-generated analyses are robust and trustworthy for clinical decision-making.
基金supported by the Major Science and Technology Project of Hainan Province(ZDKJ2021012)National Natural Science Foundation of China(32071805)the National Key Research and Development Program of China(2023YFD2200700)。
文摘Coconut(Cocos nucifera L.)is a key tropical economic tree valued for its fruit flavor,particularly 2-acetyl-1-pyrroline(2AP),a vital aroma metabolite.To enhance high-aromatic coconut breeding efforts,it is essential to deeply understand the hereditary factors governing the production of 2AP.In this study,a genome-wide association analysis identifies 32 loci that exhibit significant associations with 2AP content based on single nucleotide polymorphism(SNP)variations from 168 aromatic coconut germplasm resources.Transcriptome analysis then pinpoints 22 candidate genes near significant loci involved in 2AP metabolism.Proteins encoded by these genes are involved in amino acid metabolism,glycolysis,and secondary metabolism.Among these,Asparagine synthetase coding gene ASN1,Gamma-glutamylcysteine synthetase coding gene GSH1,and UbiA prenyltransferase coding gene UBIA are enriched in the linkage region constructed by significant locus Chr04_61490504.In particular,the SNP mutation of CnASN1 leads to amino acid changes in the functional region of the coding protein,potentially resulting in differences in 2AP content among haplotype populations.Identifying variations in related candidate genes,particularly the gene CnASN1,provides molecular markers closely associated with 2AP synthesis for coconut breeding and offers further insights into the metabolic mechanisms of 2AP.
基金supported by the National Natural Science Foundation of China(No.42177177).
文摘It is of critical importance to determine the endpoint of stabilization for landfills that are stabilized by aeration acceleration.Current stabilization evaluation methods are inconsistent and mostly fail to account for the effect of oxygen concentration.In this study,degradation experiments were conducted to quantitatively analyze the impact of oxygen on microbial communities and metabolic functions.High-throughput sequencing analysis demonstrated that an oxygen concentration exceeding 10%significantly enhances amino acid metabolism,secondary metabolite biosynthesis,and exogenous biodegradation.Three-dimensional fluorescence data were analyzed using the PARAFAC method,and a novel fluorescence-based stabilization indicator was proposed based on the ratio of fulvic-like to tyrosine-like substances.When the growth multiples of the fluorescence index exceed 10-fold,it can be inferred that degradation has been met the stabilization endpoint.Principal component analysis was employed to establish multiple regression equations between the physicochemical parameters of landfill waste and dissolved fluorescent substants,offering an innovative insight to evaluate the stabilization process of aerated landfills.
基金supported by the Northeast Asia Biodiversity Research Center(grant number 411147021003).
文摘The predominant causal agent of poplar leaf blight is the pathogenic fungus Alternaria alternata (Fr.) Keissl., which exhibits host specificity toward Populus species. To elucidate the molecular response mechanisms of A. alternata under fludioxonil fungicide stress, the fungus was cultured at the half-maximal effective concentration (EC₅₀) of fludioxonil. Transcriptomic and metabolomic profiles were analyzed using mycelia harvested under these conditions. Comparative analysis revealed 1,001 differentially expressed genes (DEGs) in the resistant strain (RS) relative to the wild-type strain (WT), comprising 628 upregulated and 373 downregulated genes. Concurrently, 524 differentially accumulated metabolites (DAMs) were identified, with 336 upregulated and 188 downregulated metabolites. KEGG pathway enrichment demonstrated pronounced upregulation in glycerophospholipid metabolism, α-linolenic acid metabolism, nucleic acid biosynthesis, and glycosylation processes. Conversely, arachidonic acid and galactose metabolism pathways were suppressed. Significant downregulation was observed in phosphatidylinositol signaling, aflatoxin biosynthesis, and cutin/suberin/wax biosynthesis pathways. Transcriptomic profiling further indicated that upregulated DEGs were predominantly associated with amino sugar/nucleotide sugar metabolism, ABC transporters, aflatoxin biosynthesis, and purine metabolism, while downregulated DEGs were enriched in N-glycan biosynthesis, endoplasmic reticulum protein processing, steroid biosynthesis, and riboflavin metabolism. Fludioxonil exerted substantial inhibitory effects on fungal growth, pathogenicity, and metabolic activity. Mechanistically, A. alternata counteracted fungicide-induced stress through modulation of its antioxidant defense system. This integrative multi-omics study delineates the dynamic gene expression and metabolic reprogramming in A. alternata under fludioxonil exposure, providing novel insights into potential molecular targets and informing the development of next-generation fungicidal strategies for phytopathogen control.
文摘BACKGROUND Hepatocellular carcinoma(HCC)is among the most aggressive primary liver cancers,leading to significant global mortality.While early diagnosis improves prognosis,treatment decisions,particularly between surgical resection and radiofrequency ablation(RFA),remain controversial.AIM To clarify this issue using sentiment analysis of medical literature alongside a meta-analysis of overall survival(OS).METHODS We included studies comparing liver resection and RFA,excluding case reports,editorials,and studies without relevant outcomes.A systematic search in PubMed and Web of Science identified 197 studies.Abstracts underwent sentiment analysis using Python’s Natural Language Toolkit library,categorizing them as favoring resection,ablation,or neutral.We also performed a meta-analysis using a random-effects model on 11 studies reporting hazard ratios(HRs)for OS.RESULTS Sentiment analysis revealed that 75.1%of abstracts were neutral,14.2%favored resection,and 10.7%favored RFA.The meta-analysis showed a significant survival advantage for liver resection,with a pooled HR of 0.5924(95%confidence interval:0.540-0.649).Heterogeneity was moderate(I²=39.98%).Despite the meta-analysis demonstrating clear survival benefits of liver resection,most abstracts maintained a neutral stance.This discrepancy highlights potential biases or hesitancy in drawing definitive conclusions.CONCLUSION The study emphasizes the need for clinicians to prioritize robust statistical evidence over narrative impressions.Liver resection remains the preferred treatment for HCC in eligible patients.
文摘[Objectives]To evaluate the impact of nasal insulin administration on postoperative delirium(POD)through meta-analysis.[Methods]The Cochrane Library,PubMed,Embase,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang Database,and China Science and Technology Journal Database(CSTJ)were systematically searched for relevant literature published prior to February 27,2025.Literature screening and data extraction were conducted by two independent researchers in accordance with predetermined inclusion and exclusion criteria.The primary observation indicator was the incidence of POD across various treatment populations.The risk ratio for the primary outcome was calculated using the Mantel-Haenszel method.The secondary outcomes included the adverse effects associated with insulin treatment,which encompassed the glycemic variability indices,the incidence of nasal irritation symptoms following administration,hypoglycemic reactions,and insulin allergic reactions.The study protocol was registered on PROSPERO(CRD420250607492)before data extraction.[Results]A total of five randomized controlled trials involving 357 patients were included in the analysis.In the adult population undergoing surgical procedures,the administration of insulin via nasal delivery was found to significantly reduce the incidence of POD[RR=0.35,95%CI(0.23-0.53),P<0.001].The results of the subgroup analysis indicated that there were notable differences in the effectiveness of various doses of insulin administered nasally in preventing POD.Specifically,both the 20 U dose group[RR=0.45,95%CI:(0.29,0.70),P<0.001]and the 30 U dose group[RR=0.01,95%CI:(0.03,0.42),P<0.001]showed a significantly lower incidence of POD compared to the control group,with statistically significant conclusions.Conversely,the 40 U dose group[RR=0.47,95%CI:(0.17,1.34),P=0.16]yielded no statistically significant difference.Furthermore,the efficacy in preventing POD was found to be greater in the 30 U dose group compared to the 20 U dose group.Additionally,two cases of hypoglycemic reactions and increased nasal irritation symptom scores were reported in the 40 U dose group across the entire study population(P<0.05),suggesting potential adverse risks associated with this dosage.[Conclusions]The nasal administration of insulin significantly decreases the incidence of POD at a specific dosage,with optimal efficacy and high safety observed at a dosage of 30 U.
基金supported by the Agricultural Science and Technology Innovation Program,Institute of Food Science and Technology,Chinese Academy of Agricultural Sciences under Grant CAAS-ASTIP-2023-IFSTGuangdong Provincial Key R&D Programme(2023B0202080003).
文摘Alzheimer’s dementia(AD)and type 2 diabetes(T2D)are interrelated global public health problems,and the current epidemics of both AD and T2D are insulin resistance diseases.Thus,AD and T2D may share common risk factors such as an unhealthy diet,lifestyle,and obesity.Meat products is an important part of the diet of consumers worldwide.This systematic review and meta-analysis aims to assess and estimate the effect of meat products consumption on AD and T2D in humans.Web of Science,MEDLINE,PubMed,Cochrane Library,and Embase were searched from January 2012 to April 2024.29 articles reported 32 cohort studies with 1785769 subjects,with 3546 AD cases and 91092 T2D cases that met the inclusion criteria and were included in our analysis.Consumption of various meat products increased the risk of T2D(hazard ratios(HR)=1.19,95%confidence intervals(CI):1.13−1.26,P=0.000;I2=88.5%),consumption of smoked,grilled/roasted and fried meat products was more likely to induce T2D(HR=1.24,95%CI:1.18−1.30,P=0.000;I2=76.1%),but was borderline significant for the risk of AD(HR=1.11,95%CI:0.98−1.25,P=0.094;I2=58.8%),with consumption of mainly livestock and poultry products increasing the risk(HR=1.21,95%CI:1.03−1.42,P=0.017;I2=66.8%).The association between meat products consumption and AD risk was influenced by meat type and sample size,while the risk of T2D was influenced by meat type,follow-up and sex.A daily intake of 27,123 and 170 g of livestock products increased the risk of T2D by 10%,51%and 70%respectively,whereas the risk of T2D was reduced when the intake of various meat products was less than 23 g/day.
