Overweight and obesity are significant public health concerns worldwide due to their association with many chronic health conditions.This has resulted in the development of various interventions focused on weight loss...Overweight and obesity are significant public health concerns worldwide due to their association with many chronic health conditions.This has resulted in the development of various interventions focused on weight loss to reduce the associated health burden.Physical activity is an important lifestyle behavior associated with enhanced health.Evidence supports that many of the benefits of physical activity are realized independent of initial weight status or whether weight loss is achieved,with some benefits additive to what is achieved with weight loss alone.These benefits include enhanced cardiometabolic,brain,cognitive and psychological health,and others.Moreover,in adults with overweight or obesity,physical activity has independent effects on cardiorespiratory fitness,muscular strength,physical function,and mobility.There are also benefits to body composition,with physical activity improving the quality of key tissues,such as skeletal muscle,which may not occur with diet-induced weight loss.Therefore,physical activity is an important public health target for adults with overweight or obesity to provide a wide range of health benefits that extend beyond those of weight loss alone.However,physical activity recommendations and programming efforts should consider the unique characteristics of adults with overweight or obesity to be most effective,and should support a focus on mobility,physical function,and other health outcomes.展开更多
Background: In the global burden of non-communicable diseases, the top slot among them all is occupied by various cardiovascular diseases (CVD), which also claim primacy in mortality rates. Generally speaking, the pat...Background: In the global burden of non-communicable diseases, the top slot among them all is occupied by various cardiovascular diseases (CVD), which also claim primacy in mortality rates. Generally speaking, the pathophysiological pathway frequently involves either (or a combination of) elevated serum cholesterol levels, predominantly attributed to dietary patterns characterized by extremely high levels of saturated and trans-fat consumption. Day-to-day nutritional epidemiology among university students suggests that they represent a crucial demographic for the study of preventive interventions. Objective: This in-depth study and investigation were specifically aimed to quantitatively assess and compare prevailing patterns of dietary fat consumption between female students enrolled in health sciences and non-health sciences programs at major universities in Riyadh, Saudi Arabia. Methodology: This cross-sectional study was comprised of 434 Saudi female university students (age range: 18 - 25 years), utilizing a validated Block Dietary Fat Screener accompanied by anthropometric measurements and comprehensive demographic data collection. The sampling methodology consisted of a snowball technique that was spread across three major academic institutions in Riyadh. Results: Statistical analysis revealed a significant association between academic specialization and patterns of dietary fat consumption (p = 0.012). Paradoxically, students of health science exhibited a higher prevalence of very high fat intake (41.9%) compared with their non-health sciences counterparts (27.6%). Surprisingly, anthropometric stratification revealed that it was the underweight students who demonstrated very high levels of fat consumption. A notable socioeconomic gradient was observed, with students from households earning 15,000 - 20,000 SR monthly showing the highest prevalence of very high-fat consumption (47.1%), although this association did not achieve statistical significance (p = 0.104). Conclusion: These findings challenge the conventional assumption that health sciences education correlates with superior dietary behaviors. The data suggests a critical need for enhanced education in nutrition, as well as intervention using various behavioral programs across all academic disciplines, particularly those addressing the disconnect between nutritional knowledge and dietary practices among students of health sciences. Future longitudinal studies are warranted in order to elucidate the temporal relationship between academic specialization and dietary behaviors.展开更多
Chronic cerebral hypoperfusion can lead to neuronal necrosis,trigger inflammatory responses,promote white matter damage,and ultimately result in cognitive impairment.Consequently,chronic cerebral hypoperfusion is an i...Chronic cerebral hypoperfusion can lead to neuronal necrosis,trigger inflammatory responses,promote white matter damage,and ultimately result in cognitive impairment.Consequently,chronic cerebral hypoperfusion is an important factor influencing the onset and progression of vascular dementia.The myelin sheath is a critical component of white matter,and damage and repair of the white matter are closely linked to myelin sheath integrity.This article reviews the role of microglia in vascular dementia,focusing on their effects on myelin sheaths and the potential therapeutic implications.The findings suggest that ischemia and hypoxia cause disruption of the blood-brain barrier and activate microglia,which may worsen blood-brain barrier damage through the release of matrix-degrading enzymes.Microglia-mediated metabolic reprogramming is recognized as an important driver of inflammation.Damage to the blood-brain barrier and subsequent inflammation can lead to myelin injury and accelerate the progression of vascular dementia.Early activation of microglia is a protective response that contributes to the maintenance of blood-brain barrier integrity through sensing,debris-clearing,and defensive mechanisms.However,prolonged activation can trigger a shift in microglia toward the pro-inflammatory M1 phenotype,resulting in myelin damage and cognitive impairment.Triggering receptor expressed on myeloid cells 2 and triggering receptor expressed on myeloid cells 1 have been identified as potential biomarkers for vascular dementia,as both are closely linked to cognitive decline.Although effective clinical treatments for myelin damage in the central nervous system are currently lacking,researchers are actively working to develop targeted therapies.Several drugs,including nimodipine,dopaminergic agents,simvastatin,biotin,and quetiapine,have been evaluated for clinical use in treating microglial and myelin damage.Future research will face challenges in developing targeted therapeutic strategies for vascular dementia,requiring further investigation into the timing,duration,and specific mechanisms of microglial activation,as well as the exploration of new drug combinations and additional therapeutic targets.展开更多
Recent evidence suggests that ferroptosis plays a crucial role in the occurrence and development of white matter lesions.However,the mechanisms and regulatory pathways involved in ferroptosis within white matter lesio...Recent evidence suggests that ferroptosis plays a crucial role in the occurrence and development of white matter lesions.However,the mechanisms and regulatory pathways involved in ferroptosis within white matter lesions remain unclear.Long non-coding RNAs(lnc RNAs)have been shown to influence the occurrence and development of these lesions.We previously identified lnc_011797 as a biomarker of white matter lesions by high-throughput sequencing.To investigate the mechanism by which lnc_011797 regulates white matter lesions,we established subjected human umbilical vein endothelial cells to oxygenglucose deprivation to simulate conditions associated with white matter lesions.The cells were transfected with lnc_011797 overexpression or knockdown lentiviruses.Our findings indicate that lnc_011797 promoted ferroptosis in these cells,leading to the formation of white matter lesions.Furthermore,lnc_011797 functioned as a competitive endogenous RNA(ce RNA)for mi R-193b-3p,thereby regulating the expression of WNK1 and its downstream ferroptosis-related proteins.To validate the role of lnc_011797 in vivo,we established a mouse model of white matter lesions through bilateral common carotid artery stenosis.The results from this model confirmed that lnc_011797 regulates ferroptosis via WNK1 and promotes the development of white matter lesions.These findings clarify the mechanism by which lnc RNAs regulate white matter lesions,providing a new target for the diagnosis and treatment of white matter lesions.展开更多
Light plays an essential role in psychobiological and psychophysiological processes,such as alertness.The alerting effect is influenced by light characteristics and the timing of interventions.This meta-analysis is th...Light plays an essential role in psychobiological and psychophysiological processes,such as alertness.The alerting effect is influenced by light characteristics and the timing of interventions.This meta-analysis is the first to systematically review the effect of light intervention on alertness and to discuss the optimal protocol for light intervention.In this meta-analysis,registered at PROSPERO(Registration ID:CRD42020181485),we conducted a systematic search of the Web of Science,PubMed,and PsycINFO databases for studies published in English prior to August 2021.The outcomes included both subjective and objective alertness.Subgroup analyses considered a variety of factors,such as wavelength,correlated color temperature(CCT),light illuminance,and timing of interventions(daytime,night-time,or all day).Twenty-seven crossover studies and two parallel-group studies were included in this meta-analysis,with a total of 1210 healthy participants(636(52%)male,mean age 25.62 years).The results revealed that light intervention had a positive effect on both subjective alertness(standardized mean difference(SMD)=-0.28,95%confidence interval(CI):-0.49 to-0.06,P=0.01)and objective alertness in healthy subjects(SMD=-0.34,95%CI:-0.68 to-0.01,P=0.04).The subgroup analysis revealed that cold light was better than warm light in improving subjective alertness(SMD=-0.37,95%CI:-0.65 to-0.10,P=0.007,I2=26%)and objective alertness(SMD=-0.36,95%CI:-0.66 to-0.07,P=0.02,I2=0).Both daytime(SMD=-0.22,95%CI:-0.37 to-0.07,P=0.005,I2=74%)and night-time(SMD=-0.32,95%CI:-0.61 to-0.02,P=0.04,I2=0)light exposure improved subjective alertness.The results of this meta-analysis and systematic review indicate that light exposure is associated with significant improvement in subjective and objective alertness.In addition,light exposure with a higher CCT was more effective in improving alertness than light exposure with a lower CCT.Our results also suggest that both daytime and night-time light exposure can improve subjective alertness.展开更多
The National Natural Science Foundation of China is one of the major funding agencies for neuro rehabilitation research in China.This study reviews the frontier directions and achievements in the field of neurorehabil...The National Natural Science Foundation of China is one of the major funding agencies for neuro rehabilitation research in China.This study reviews the frontier directions and achievements in the field of neurorehabilitation in China and wo rldwide.We used data from the Web of Science Core Collection(WoSCC) database to analyze the publications and data provided by the National Natural Science Foundation of China to analyze funding information.In addition,the prospects for neurorehabilitation research in China are discussed.From 2010 to 2022,a total of 74,220 publications in neurorehabilitation were identified,with there being an overall upward tendency.During this period,the National Natural Science Foundation of China has funded 476 research projects with a total funding of 192.38 million RMB to support neuro rehabilitation research in China.With the support of the National Natural Science Foundation of China,China has made some achievements in neurorehabilitation research.Research related to neurorehabilitation is believed to be making steady and significant progress in China.展开更多
Background and purpose:Cerebellar ataxia,neuropathy,and vestibular areflexia syndrome(CANVAS)is a neurodegenerative disease of the cerebellum.The disease progression is slow,with up to 25%of people diagnosed needing t...Background and purpose:Cerebellar ataxia,neuropathy,and vestibular areflexia syndrome(CANVAS)is a neurodegenerative disease of the cerebellum.The disease progression is slow,with up to 25%of people diagnosed needing to use a wheelchair after 15 years from diagnosis.Vestibular symptoms arise from centrally-mediated ocular movement degradation and the reduced vestibular-ocular reflex functioning bilaterally.To date,no report has shown an improvement in VOR gain or gait outcome measures in someone with CANVAS after a course of vestibular physical therapy.Case description:A 65-year-old male,Patient X,first noticed symptoms in his fourth decade of life and was diagnosed with(CANVAS)in his seventh decade.Patient X reported numbness and tingling in his hands and feet,decreased ability to perform daily activities,and several falls.Intervention:Patient X completed a four-month course of vestibular physical therapy,including vestibular ocular reflex exercises,balance training,gait training,and the VestAid application for eye gaze compliance monitoring.The Vestaid application uses eyes and facial recognition software to record the percentage of time that the patient kept their eyes on the target.Outcomes:After vestibular therapy,Patient X had a clinically meaningful improvement in gait speed:from 1.02 m/s to 1.13 m/s and in the Functional Gait Assessment from 20/30 to 27/30.Patient X's eye gaze compliance improved from a median of 43%(range 25e68%)to a median of 67%(58e83%).Discussion:This case study demonstrates that vestibular rehabilitation improved eye gaze compliance and functional outcomes in a person living with CANVAS.展开更多
<span style="font-family:Verdana;"><strong>Background:</strong></span><span "=""><span style="font-family:Verdana;"> Ea</span><span>&l...<span style="font-family:Verdana;"><strong>Background:</strong></span><span "=""><span style="font-family:Verdana;"> Ea</span><span><span style="font-family:Verdana;">rly intervention is beneficial for improving preterm infant motor and cognitive outcomes in early childhood;however, little is known about whether early intervention can influence a preterm infant’s participation. Additionally, many studies investigating the impact of early intervention for preterm infants have been conducted in large metropolitan centres, leaving preterm infants who reside i</span><span style="font-family:Verdana;">n regional areas underrepresented in the literature to date. Consequentia</span></span><span style="font-family:Verdana;">lly, it is not yet known whether there are service delivery models, such as using telehealth as an adjunct to face-to-face intervention, that might cater to the needs of preterm infants residing outside metropolitan centres. PreEMPT (Preterm infant Early intervention for Movement and Participation Trial) is a novel early physiotherapy intervention that has been designed to use a participation goal-directed intervention approach via a mixture of face-to-face clinic sessions and telehealth sessions to improve the motor and participation outcomes of preterm born infants. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This study aims to evaluate the feasibility of PreEMPT using an assessor-blinded, randomised controlled trial to compare PreEMPT to Usual Physiotherapy Care (UPC) for preterm infants residing in a regional Australian hospital catchment area. Twenty-six preterm infants (≤34 + 6 weeks gestational age) will be recruited prior to term corrected age from the special care nursery of a regional hospital. Following informed consent and baseline assessments, infants will be randomly allocated to receive either PreEMPT, a novel participation-focused early physiotherapy intervention delivered weekly for 14 forty-five-minute sessions alternating face-to-face sessions with telehealth into the infant’s home, or UPC, two - three physiotherapy sessions in the 4-month intervention period. Outcome measures relating to infant neuromotor development, motor performance, general development, and parental mental health and well-being will be assessed at 4-, 6- and 8-months corrected age. Feasibility will be evaluated by acceptability (parental satisfaction), demand and practicality (recruitment rate and telehealth session implementation), implementation (attendance at assessment and treatment sessions), and limited efficacy testing (comparing outcomes listed above for infants in PreEMPT and UPC). </span><b><span style="font-family:Verdana;">Discussion:</span></b><span style="font-family:Verdana;"> This study will be the first of its kind to use the participation of preterm infants in meaningful life situations as the foundation for intervention delivered via alternating face-to-face clinic sessions with telehealth into the home. The feasibility of this approach will be evaluated and used to inform future iterations of research about PreEMPT’s efficacy for improving preterm infant motor and participation outcomes.</span></span>展开更多
Colorectal cancer(CRC)ranks among the top causes of cancer-related fatalities globally.Recent progress in genomics,proteomics,and bioinformatics has greatly improved our comprehension of the molecular underpinnings of...Colorectal cancer(CRC)ranks among the top causes of cancer-related fatalities globally.Recent progress in genomics,proteomics,and bioinformatics has greatly improved our comprehension of the molecular underpinnings of CRC,paving the way for targeted therapies and immunotherapies.Nonetheless,obstacles such as tumor heterogeneity and drug resistance persist,hindering advancements in treatment efficacy.In this context,the integration of artificial intelligence(AI)and organoid technology presents promising new avenues.AI can analyze genetic and clinical data to forecast disease risk,prognosis,and treatment responses,thereby expediting drug development and tailoring treatment plans.Organoids replicate the genetic traits and biological behaviors of tumors,acting as platforms for drug testing and the formulation of personalized treatment approaches.Despite notable strides in CRC research and treatment-from genetic insights to therapeutic innovations-numerous challenges endure,including the intricate tumor microen-vironment,tumor heterogeneity,adverse effects of immunotherapies,issues related to AI data quality and privacy,and the need for standardization in organoid culture.Future initiatives should concentrate on clarifying the pathogenesis of CRC,refining AI algorithms and organoid models,and creating more effective therapeutic strategies to alleviate the global impact of CRC.展开更多
Background:Community-based first responders face high levels of workplace stressors that can pro-foundly impact their physical and mental health.Mindfulness-based interventions have shown promise in decreasing stress ...Background:Community-based first responders face high levels of workplace stressors that can pro-foundly impact their physical and mental health.Mindfulness-based interventions have shown promise in decreasing stress and increasing psychological resilience;however,implementation is difficult due to unpredictability of the job,department culture,and generational preferences.The objective of this qualitative study was to identify and enhance understanding of the specific needs and potential barriers and facilitators for the implementation of mindfulness-based programming for community-based first responders.Methods:A phenomenological qualitative study design was used to gain insights into the lived experiences of first responders and elicit perceptions regarding barriers and facilitators for engaging in mindfulness activities.During virtual semi-structured interviews,eleven career firefighters and emergency medical service(EMS)providers offered feedback relative to worksite mindfulness practices,and the use of a stress reduction smartphone application.The Consolidated Framework for Implementation Research was used to guide the analysis relative to barriers and facilitators of implementation success and sustainability.Results:First responders expressed openness to mindfulness-based interventions and a smartphone app that would provide stress reduction content,however,they were adamant that programming needed to be accessible and easily integrated into their workday.They also reinforced that organizational culture and leadership support for their health and well-being were overarching factors essential for implementation success.Conclusions:First responders were supportive of evidence-based mindfulness practices,optimally developed and/or facilitated by someone with intimate knowledge of their unique work environments and challenges.Organizational culture and leadership support were essential for implementation success and sustainability.展开更多
BACKGROUND Proximal gastrectomy(PG)for gastric cancer requires a delicate balance between oncological radicality and postoperative quality of life to mitigate reflux complications.Although the Kamikawa anastomosis has...BACKGROUND Proximal gastrectomy(PG)for gastric cancer requires a delicate balance between oncological radicality and postoperative quality of life to mitigate reflux complications.Although the Kamikawa anastomosis has gained attention for its theoretical anti-reflux advantages,robust clinical evidence remains limited.AIM To comprehensively evaluate the efficacy,safety,and nutritional outcomes of the Kamikawa anastomosis in PG,thereby addressing a critical gap in surgical decision-making.METHODS Following PRISMA guidelines,we systematically searched PubMed,Embase,and the Cochrane Library for studies on Kamikawa anastomosis after PG.Data were pooled using fixed-or random-effects models based on heterogeneity levels(I2 statistics).The risk of bias was evaluated using Risk of Bias in Non-randomized Studies of Interventions.The protocol was prospectively registered in PROSPERO.RESULTS Of 106 screened studies,20 involving 2291 patients were included.Most studies(85%)originated from Japan,with a mean patient age of 54-73 years and a male predominance(68.1%).Overall pooled incidence of 30-day postoperative complications was 9.9%[95%confidence interval(95%CI):6.8-12.9],with major complications(Clavien-Dindo grade≥III)occurring in 6.1%(95%CI:4.6-7.7).Anastomosis-related complications were observed in 7.2%of cases,comprising leakage 1.8%(95%CI:1.1-2.4),stenosis in 7.2%(95%CI:5.8-8.5),and bleeding in 0.7%(95%CI:0.1-1.2).Pooled incidence of reflux esophagitis was 4%(95%CI:2.7-5.3)for all LA grades at 12-month follow-up,with 28.3%(95%CI:14.7-41.9)of patients requiring regular proton pump inhibitor use.Operative outcomes demonstrated a pooled mean operative time of 349.5 minutes(95%CI:331-380),estimated blood loss of 351.5 mL(95%CI:264-495),and postoperative hospital stay of 12.3 days(95%CI:11.5-13.1).Nutritional outcomes revealed 11.4%(95%CI:10.6-12.2)body weight loss at one year.Comparative analyses showed equivalent safety profiles between the Kamikawa anastomosis and double-tract reconstruction but longer operative times(P<0.001)compared with total gastrectomy.CONCLUSION These findings underscore the clinical viability of the Kamikawa anastomosis following PG,demonstrating favorable anti-reflux efficacy,acceptable incidence of anastomotic strictures,and preservation of nutritional status.展开更多
Reach-to-grasp movements require integrating information on both object location and grip type,but how these elements are planned and to what extent they interact remains unclear.We designed a new experimental paradig...Reach-to-grasp movements require integrating information on both object location and grip type,but how these elements are planned and to what extent they interact remains unclear.We designed a new experimental paradigm in which monkeys sequentially received reach and grasp cues with delays,requiring them to retain and integrate both cues to grasp the goal object with appropriate hand gestures.Neural activity in the dorsal premotor cortex(PMd)revealed that reach and grasp were similarly represented yet not independent.Upon receiving the second cue,the PMd continued encoding the first,but over half of the neurons displayed incongruent modulations:enhanced,attenuated,or even reversed.Population-level analysis showed significant changes in encoding structure,forming distinct neural patterns.Leveraging canonical correlation analysis,we identified a shared subspace preserving the initial cue’s encoding,contributed by both congruent and incongruent neurons.Together,these findings reveal a novel perspective on the interactive planning of reach and grasp within the PMd,providing insights into potential applications for brain–machine interfaces.展开更多
Liver diseases,particularly acute alcoholic liver injury(AALI),drug-induced liver injury(DILI),and hepatocellular carcinoma(HCC),have become global public health issues.Glutathione(GSH),as an important antioxidant,pla...Liver diseases,particularly acute alcoholic liver injury(AALI),drug-induced liver injury(DILI),and hepatocellular carcinoma(HCC),have become global public health issues.Glutathione(GSH),as an important antioxidant,plays a crucial role in the liver,and its changes are closely associated with liver injury and the development of liver cancer.Therefore,accurately monitoring GSH variations is critical for understanding liver injury mechanisms,early diagnosis,and treatment evaluation.However,traditional detection methods suffer from insufficient sensitivity and selectivity.To address these challenges,we developed an innovative DR-Au^(3+)/DR-Pd^(2+)complex probe that can rapidly and sensitively detect GSH through near-infrared(NIR)fluorescence changes.This probe,with the optimal excitation and emission wavelengths of the probe both located in the NIR region,exhibits excellent selectivity and liver-targeting ability,overcoming the imprecision localization problems of traditional methods.In the AALI and DILI models,the optimized DR-Au^(3+)probe enables real-time monitoring of GSH level fluctuations,providing a powerful tool for early diagnosis of liver injury and dynamic evaluation of therapeutic efficacy.In the DILI and HCC models,the DR-Au^(3+)probe enables visualization and quantitative monitoring of the ferroptosis process,offering new perspectives and approaches for targeted therapy research.The DR-Au^(3+)probe we developed pioneers innovative strategies for establishing accurate diagnostic protocols and individualized therapeutic regimens in hepatic injury and hepatocellular carcinoma management.展开更多
Efficient reconstruction of severe cutaneous wounds necessitates the orchestration of effective cell-mediated matrix remodeling and robust protection against microbial invasion.Herein,we engineered a near-infrared lig...Efficient reconstruction of severe cutaneous wounds necessitates the orchestration of effective cell-mediated matrix remodeling and robust protection against microbial invasion.Herein,we engineered a near-infrared light(NIR)-stimulated,thermo-responsive bilayer system based on a drug-loaded hydrogel with a thermal-responsive temperature of~42℃ as the matrix layer and an antibacterial nanofibrous mat as the top layer.The matrix layer integrates basic fibroblast growth factor(bFGF)-loaded thermosensitive gelatin(Gel)hydrogel with polydopamine-Cu^(2+)coated short nanofibers(P@SF).Upon NIR exposure,P@SF elicits a photothermal effect,causing a rapid increase in temperature by 13.4℃ within 1 min at a power density of 0.75 W/cm^(2),which triggers the gel-sol transition of Gel and controls the release of bFGF.This,in turn,enhances fibroblast and endothelial cells ingrowth into the hydrogel,fostering cell functionalization and matrix remodeling.The top layer consists of poly(L-lactide-co-caprolactone)nanofibers functionalized with lysine-doped polydopamine and poly-l-lysine.It possesses antibacterial efficacy by isolating,controlling(76.23%for E.coli and 89.16%for S.aureus),and eliminating bacteria upon NIR activation.In rat skin wound models,this NIR-responsive smart bilayer system prevents S.aureus-mediated bacterial infection(indicative of reduced IL-6 expression),regulates CD31-positive neovascularization,and facilitates collagen remodeling for skin regeneration.In summary,this study introduces a novel strategy,inspired by the centralization of authority,for developing a smart thermo-responsive system with promising potential for the effective reconstruction of severe cutaneous wounds.展开更多
BACKGROUND Protein-losing enteropathy(PLE)is a rare cause of hypoalbuminemia that can be attributed to intestinal lymphangiectasia.Patients with Noonan syndrome may present with disorder of lymph vessel formation.Howe...BACKGROUND Protein-losing enteropathy(PLE)is a rare cause of hypoalbuminemia that can be attributed to intestinal lymphangiectasia.Patients with Noonan syndrome may present with disorder of lymph vessel formation.However,PLE is rarely reported with Noonan syndrome.CASE SUMMARY A 15-year-old female was hospitalized multiple times for recurrent edema and diarrhea secondary to hypoalbuminemia.Additional manifestations included a ventricular septal defect at birth,intermuscular hemangioma,slightly wide interocular and intermammary distances,and absence of the distal phalanx of the left little finger since birth.Abdominal computed tomography revealed cavernous transformation of the portal vein,and liver biopsy indicated“porto-sinusoidal vascular disease”.Whole exome and Sanger sequencing revealed a heterozygous mutation(exon9:C.850C>T:P.R284C)in leucine zipper-like transcription regulator 1,suggesting Noonan syndrome type 10.Further examinations revealed thoracic duct dysplasia and intestinal lymphangiectasia causing PLE in this patient.A multidisciplinary team decided to address thoracic duct dysplasia with outlet obstruction.Approximately two years after the microsurgical relief of the thoracic duct outlet obstruction,the patient achieved persistent normal serum albumin level without edema or diarrhea.Furthermore,the relevant literatures on Noonan syndrome and PLE were reviewed.CONCLUSION Herein,we reported the first case of PLE associated with Noonan syndrome caused by a rare genetic mutation in leucine zipper-like transcription regulator 1(c.850C>T:P.R284C)with newly reported manifestations.This case presented the successful treatment of clinical hypoalbuminemia attributed to thoracic duct dysplasia,intestinal lymphangiectasia and PLE.展开更多
Background:Scientific animal models are indispensable for studying trauma repair.This work aimed at establishing a more scientific rat trauma model by studying different rat trauma models caused by different trauma nu...Background:Scientific animal models are indispensable for studying trauma repair.This work aimed at establishing a more scientific rat trauma model by studying different rat trauma models caused by different trauma numbers,locations,and trauma attachment tension unloaders and rat age.Methods:A four-trauma self-upper,lower,left and right control model;a two-trauma self-trauma bare and ring control model;and a young and old rat trauma model were created to evaluate the condition of these traumas.Results:In the four-trauma self-control model,the healing status of the upper proximal cephalic trauma was better than that of the lower proximal caudal trauma,whereas there was no significant difference between the left and right trauma.The healing rate and postwound condition of the trauma with a ring control in the two-trauma model were better than those of the bare side.The healing speed of the old rats was slower,and the amount of extracellular matrix in the subcutaneous tissue after healing was significantly lower than that of the young rats.Conclusion:The double trauma with a ring is a more scientific and reasonable experimental model.There is a significant difference between young and old rats in the wound healing process.Therefore,the appropriate age of the rats should be selected according to the main age range of the patients with similar conditions in the clinical setting being mimicked.展开更多
Motion intention recognition is considered the key technology for enhancing the training effectiveness of upper limb rehabilitation robots for stroke patients,but traditional recognition systems are difficult to simul...Motion intention recognition is considered the key technology for enhancing the training effectiveness of upper limb rehabilitation robots for stroke patients,but traditional recognition systems are difficult to simultaneously balance real-time performance and reliability.To achieve real-time and accurate upper limb motion intention recognition,a multi-modal fusion method based on surface electromyography(sEMG)signals and arrayed flexible thin-film pressure(AFTFP)sensors was proposed.Through experimental tests on 10 healthy subjects(5 males and 5 females,age 23±2 years),sEMG signals and human-machine interaction force(HMIF)signals were collected during elbow flexion,extension,and shoulder internal and external rotation.The AFTFP signals based on dynamic calibration compensation and the sEMG signals were processed for feature extraction and fusion,and the recognition performance of single signals and fused signals was compared using a support vector machine(SVM).The experimental results showed that the sEMG signals consistently appeared 175±25 ms earlier than the HMIF signals(p<0.01,paired t-test).In offline conditions,the recognition accuracy of the fused signals exceeded 99.77%across different time windows.Under a 0.1 s time window,the real-time recognition accuracy of the fused signals was 14.1%higher than that of the single sEMG signal,and the system’s end-to-end delay was reduced to less than 100 ms.The AFTFP sensor is applied to motion intention recognition for the first time.And its low-cost,high-density array design provided an innovative solution for rehabilitation robots.The findings demonstrate that the AFTFP sensor adopted in this study effectively enhances intention recognition performance.The fusion of its output HMIF signals with sEMG signals combines the advantages of both modalities,enabling real-time and accurate motion intention recognition.This provides efficient command output for human-machine interaction in scenarios such as stroke rehabilitation.展开更多
Background:Taking actions to maintain a healthy lifestyle,including regular engagement in physical activity(PA)and reducing sedentary behavior(SB),may protect against the development of internalizing problems among he...Background:Taking actions to maintain a healthy lifestyle,including regular engagement in physical activity(PA)and reducing sedentary behavior(SB),may protect against the development of internalizing problems among healthy youth.However,it remains unclear whether such associations exist among youth with chronic pain who often report symptoms of depression and anxiety.To this end,we aimed to investigate the associations between independent and combined PA and/or SB patterns with indicators of internalizing problems in this vulnerable population.Methods:Data used in this cross-sectional study were retrieved from the U.S.National Survey of Children’s Health for the years 2021-2022.Specifically,caregiver proxy reports on sociodemgraphic factors and lifestyle behaviors of 4735 U.S.children and adolescents(referring to youth)aged 6-17 years were collected.We examined independent and combined patterns of PA and SB as exposures,with internalizing problems serving as outcomes of interest.Logistic regressions were used to examine the independent and combined associations of PA and/or SB patterns with anxiety and depression symptoms among youth with chronic pain while adjusting for covariates including age,sex,ethnicity,primary caregivers’education level,overweight status,and household federal poverty level.Results:Overall,our results indicated that PA was negatively associated with anxiety and depressive symptoms.Specifically,youth with chronic pain who engaged in at least 60-minute PA for 1-3 days,4-6 days,or every day reported significantly lower likelihood of experiencing symptoms of anxiety(OR=0.71,95%CI:0.60-0.84;OR=0.44,95%CI:0.36-0.53;OR=0.50,95%CI:0.40-0.63,respectively;all p-value<0.001)and depression(OR=0.63,95%CI:0.53-0.75;OR=0.38,95%CI:0.31-0.47;OR=0.46,95%CI:0.36-0.59,respectively;all p-value<0.001)symptoms compared to those with 0 days.Conversely,SB(operationalized via the proxy screen time)was positively associated with anxiety and depression symptoms.Youth with chronic pain who reported 4 or more hours of daily screen time had significantly higher odds of experiencing symptoms of anxiety(OR=2.17,95%CI:1.52-3.09,p<0.001)and depression(OR=2.30,95%CI:1.48-3.59,p<0.001).Furthermore,youth with chronic pain who engaged in higher PA levels and reported lower SB levels had a lower likelihood of experiencing symptoms of anxiety(OR=0.68,95%CI:0.52-0.87,p=0.003)and depression(OR=0.49,95%CI:0.34-0.70,p<0.001)symptoms compared to those with lower PA levels and higher SB levels.Conclusions:Higher PA levels and lower SB levels were associated with a reduced likelihood of developing anxiety and depression symptoms,which are indicative of internalizing problems,among youth with chronic pain.Future public health actions in this vulnerable population should prioritize intervention programs that promote PA engagement to reduce SB levels.展开更多
INTRODUCTION With the expansion of the ageing population,cognitive decline has become an increas-ingly pressing challenge.1 As life expectancy increases,its socioeconomic burden is also increasing,highlighting the urg...INTRODUCTION With the expansion of the ageing population,cognitive decline has become an increas-ingly pressing challenge.1 As life expectancy increases,its socioeconomic burden is also increasing,highlighting the urgent need for effective interventions.Numerous studies suggest that specific dietary patterns and nutritional interventions may help mitigate cognitive decline associated with ageing.展开更多
Background While Nordic hamstring exercise(NHE)training has been shown to reduce hamstring strains,the muscle-specific adaptations to NHE across the 4 hamstrings remain unclear.This study investigates architectural an...Background While Nordic hamstring exercise(NHE)training has been shown to reduce hamstring strains,the muscle-specific adaptations to NHE across the 4 hamstrings remain unclear.This study investigates architectural and microstructural adaptations of the biceps femoris short head(BFsh),biceps femoris long head(BFlh),semitendinosus(ST),and semimembranosus(SM)in response to an NHE intervention.Methods Eleven subjects completed 9 weeks of supervised NHE training followed by 3 weeks of detraining.Magnetic resonance imaging was performed at pre-training,post-training,and detraining to assess architectural(volume,fiber tract length,and fiber tract angle)and microstructural(axial(AD),mean(MD),radial(RD)diffusivities,and fractional anisotropy(FA))parameters of the 4 hamstrings.Results NHE training induced significant but non-uniform hamstring muscle hypertrophy(BFsh:22%,BFlh:9%,ST:26%,SM:6%)and fiber tract length increase(BFsh:11%,BFlh:7%,ST:18%,SM:10%).AD(5%),MD(4%),and RD(5%)showed significant increases,but fiber tract angle and FA remained unchanged.After detraining,only ST showed a significant reduction(8%)in volume,which remained higher than the pre-training value.While fiber tract lengths returned to baseline,AD,MD,and RD remained higher than pre-training levels for all hamstrings.Conclusion The 9-week NHE training substantially increased hamstring muscle volume with greater hypertrophy in ST and BFsh.Hypertrophy was accompanied by increases in fiber tract lengths and cross-sections(increased RD).After 3 weeks of detraining,fiber tract length gains across all hamstrings declined,emphasizing the importance of sustained training to maintain all the protective adaptations.展开更多
基金supported by the National Institutes of Health for the Kansas Center for Metabolism and Obesity Research(award No.P20GM144269)support from the Center for Advancing Translational Sciences of the National Institutes of Health(award No.KL2TR002367)supported by the National Center for Advancing Translational Sciences of the National Institutes of Health(award No.TL1TR002368)。
文摘Overweight and obesity are significant public health concerns worldwide due to their association with many chronic health conditions.This has resulted in the development of various interventions focused on weight loss to reduce the associated health burden.Physical activity is an important lifestyle behavior associated with enhanced health.Evidence supports that many of the benefits of physical activity are realized independent of initial weight status or whether weight loss is achieved,with some benefits additive to what is achieved with weight loss alone.These benefits include enhanced cardiometabolic,brain,cognitive and psychological health,and others.Moreover,in adults with overweight or obesity,physical activity has independent effects on cardiorespiratory fitness,muscular strength,physical function,and mobility.There are also benefits to body composition,with physical activity improving the quality of key tissues,such as skeletal muscle,which may not occur with diet-induced weight loss.Therefore,physical activity is an important public health target for adults with overweight or obesity to provide a wide range of health benefits that extend beyond those of weight loss alone.However,physical activity recommendations and programming efforts should consider the unique characteristics of adults with overweight or obesity to be most effective,and should support a focus on mobility,physical function,and other health outcomes.
文摘Background: In the global burden of non-communicable diseases, the top slot among them all is occupied by various cardiovascular diseases (CVD), which also claim primacy in mortality rates. Generally speaking, the pathophysiological pathway frequently involves either (or a combination of) elevated serum cholesterol levels, predominantly attributed to dietary patterns characterized by extremely high levels of saturated and trans-fat consumption. Day-to-day nutritional epidemiology among university students suggests that they represent a crucial demographic for the study of preventive interventions. Objective: This in-depth study and investigation were specifically aimed to quantitatively assess and compare prevailing patterns of dietary fat consumption between female students enrolled in health sciences and non-health sciences programs at major universities in Riyadh, Saudi Arabia. Methodology: This cross-sectional study was comprised of 434 Saudi female university students (age range: 18 - 25 years), utilizing a validated Block Dietary Fat Screener accompanied by anthropometric measurements and comprehensive demographic data collection. The sampling methodology consisted of a snowball technique that was spread across three major academic institutions in Riyadh. Results: Statistical analysis revealed a significant association between academic specialization and patterns of dietary fat consumption (p = 0.012). Paradoxically, students of health science exhibited a higher prevalence of very high fat intake (41.9%) compared with their non-health sciences counterparts (27.6%). Surprisingly, anthropometric stratification revealed that it was the underweight students who demonstrated very high levels of fat consumption. A notable socioeconomic gradient was observed, with students from households earning 15,000 - 20,000 SR monthly showing the highest prevalence of very high-fat consumption (47.1%), although this association did not achieve statistical significance (p = 0.104). Conclusion: These findings challenge the conventional assumption that health sciences education correlates with superior dietary behaviors. The data suggests a critical need for enhanced education in nutrition, as well as intervention using various behavioral programs across all academic disciplines, particularly those addressing the disconnect between nutritional knowledge and dietary practices among students of health sciences. Future longitudinal studies are warranted in order to elucidate the temporal relationship between academic specialization and dietary behaviors.
基金supported by the Natural Science Foundation of Beijing,No.7232279(to XW)the National Natural Science Foundation of China,No.U21A20400(to QW)Key Project of Beijing University of Chinese Medicine,Nos.2022-JYB-JBZR-004(to XW),2024-JYB-JBZD-043(to CL).
文摘Chronic cerebral hypoperfusion can lead to neuronal necrosis,trigger inflammatory responses,promote white matter damage,and ultimately result in cognitive impairment.Consequently,chronic cerebral hypoperfusion is an important factor influencing the onset and progression of vascular dementia.The myelin sheath is a critical component of white matter,and damage and repair of the white matter are closely linked to myelin sheath integrity.This article reviews the role of microglia in vascular dementia,focusing on their effects on myelin sheaths and the potential therapeutic implications.The findings suggest that ischemia and hypoxia cause disruption of the blood-brain barrier and activate microglia,which may worsen blood-brain barrier damage through the release of matrix-degrading enzymes.Microglia-mediated metabolic reprogramming is recognized as an important driver of inflammation.Damage to the blood-brain barrier and subsequent inflammation can lead to myelin injury and accelerate the progression of vascular dementia.Early activation of microglia is a protective response that contributes to the maintenance of blood-brain barrier integrity through sensing,debris-clearing,and defensive mechanisms.However,prolonged activation can trigger a shift in microglia toward the pro-inflammatory M1 phenotype,resulting in myelin damage and cognitive impairment.Triggering receptor expressed on myeloid cells 2 and triggering receptor expressed on myeloid cells 1 have been identified as potential biomarkers for vascular dementia,as both are closely linked to cognitive decline.Although effective clinical treatments for myelin damage in the central nervous system are currently lacking,researchers are actively working to develop targeted therapies.Several drugs,including nimodipine,dopaminergic agents,simvastatin,biotin,and quetiapine,have been evaluated for clinical use in treating microglial and myelin damage.Future research will face challenges in developing targeted therapeutic strategies for vascular dementia,requiring further investigation into the timing,duration,and specific mechanisms of microglial activation,as well as the exploration of new drug combinations and additional therapeutic targets.
基金supported by the Qingdao Medical Health Research Project,No.2023-WJZD212(to XX)。
文摘Recent evidence suggests that ferroptosis plays a crucial role in the occurrence and development of white matter lesions.However,the mechanisms and regulatory pathways involved in ferroptosis within white matter lesions remain unclear.Long non-coding RNAs(lnc RNAs)have been shown to influence the occurrence and development of these lesions.We previously identified lnc_011797 as a biomarker of white matter lesions by high-throughput sequencing.To investigate the mechanism by which lnc_011797 regulates white matter lesions,we established subjected human umbilical vein endothelial cells to oxygenglucose deprivation to simulate conditions associated with white matter lesions.The cells were transfected with lnc_011797 overexpression or knockdown lentiviruses.Our findings indicate that lnc_011797 promoted ferroptosis in these cells,leading to the formation of white matter lesions.Furthermore,lnc_011797 functioned as a competitive endogenous RNA(ce RNA)for mi R-193b-3p,thereby regulating the expression of WNK1 and its downstream ferroptosis-related proteins.To validate the role of lnc_011797 in vivo,we established a mouse model of white matter lesions through bilateral common carotid artery stenosis.The results from this model confirmed that lnc_011797 regulates ferroptosis via WNK1 and promotes the development of white matter lesions.These findings clarify the mechanism by which lnc RNAs regulate white matter lesions,providing a new target for the diagnosis and treatment of white matter lesions.
基金supported by the National Natural Science Foundation of China,No.82172530(to QT)Science and Technology Program of Guangdong,No.2018B030334001(to CRR)Guangzhou Science and Technology Project,No.202007030012(to QT).
文摘Light plays an essential role in psychobiological and psychophysiological processes,such as alertness.The alerting effect is influenced by light characteristics and the timing of interventions.This meta-analysis is the first to systematically review the effect of light intervention on alertness and to discuss the optimal protocol for light intervention.In this meta-analysis,registered at PROSPERO(Registration ID:CRD42020181485),we conducted a systematic search of the Web of Science,PubMed,and PsycINFO databases for studies published in English prior to August 2021.The outcomes included both subjective and objective alertness.Subgroup analyses considered a variety of factors,such as wavelength,correlated color temperature(CCT),light illuminance,and timing of interventions(daytime,night-time,or all day).Twenty-seven crossover studies and two parallel-group studies were included in this meta-analysis,with a total of 1210 healthy participants(636(52%)male,mean age 25.62 years).The results revealed that light intervention had a positive effect on both subjective alertness(standardized mean difference(SMD)=-0.28,95%confidence interval(CI):-0.49 to-0.06,P=0.01)and objective alertness in healthy subjects(SMD=-0.34,95%CI:-0.68 to-0.01,P=0.04).The subgroup analysis revealed that cold light was better than warm light in improving subjective alertness(SMD=-0.37,95%CI:-0.65 to-0.10,P=0.007,I2=26%)and objective alertness(SMD=-0.36,95%CI:-0.66 to-0.07,P=0.02,I2=0).Both daytime(SMD=-0.22,95%CI:-0.37 to-0.07,P=0.005,I2=74%)and night-time(SMD=-0.32,95%CI:-0.61 to-0.02,P=0.04,I2=0)light exposure improved subjective alertness.The results of this meta-analysis and systematic review indicate that light exposure is associated with significant improvement in subjective and objective alertness.In addition,light exposure with a higher CCT was more effective in improving alertness than light exposure with a lower CCT.Our results also suggest that both daytime and night-time light exposure can improve subjective alertness.
文摘The National Natural Science Foundation of China is one of the major funding agencies for neuro rehabilitation research in China.This study reviews the frontier directions and achievements in the field of neurorehabilitation in China and wo rldwide.We used data from the Web of Science Core Collection(WoSCC) database to analyze the publications and data provided by the National Natural Science Foundation of China to analyze funding information.In addition,the prospects for neurorehabilitation research in China are discussed.From 2010 to 2022,a total of 74,220 publications in neurorehabilitation were identified,with there being an overall upward tendency.During this period,the National Natural Science Foundation of China has funded 476 research projects with a total funding of 192.38 million RMB to support neuro rehabilitation research in China.With the support of the National Natural Science Foundation of China,China has made some achievements in neurorehabilitation research.Research related to neurorehabilitation is believed to be making steady and significant progress in China.
文摘Background and purpose:Cerebellar ataxia,neuropathy,and vestibular areflexia syndrome(CANVAS)is a neurodegenerative disease of the cerebellum.The disease progression is slow,with up to 25%of people diagnosed needing to use a wheelchair after 15 years from diagnosis.Vestibular symptoms arise from centrally-mediated ocular movement degradation and the reduced vestibular-ocular reflex functioning bilaterally.To date,no report has shown an improvement in VOR gain or gait outcome measures in someone with CANVAS after a course of vestibular physical therapy.Case description:A 65-year-old male,Patient X,first noticed symptoms in his fourth decade of life and was diagnosed with(CANVAS)in his seventh decade.Patient X reported numbness and tingling in his hands and feet,decreased ability to perform daily activities,and several falls.Intervention:Patient X completed a four-month course of vestibular physical therapy,including vestibular ocular reflex exercises,balance training,gait training,and the VestAid application for eye gaze compliance monitoring.The Vestaid application uses eyes and facial recognition software to record the percentage of time that the patient kept their eyes on the target.Outcomes:After vestibular therapy,Patient X had a clinically meaningful improvement in gait speed:from 1.02 m/s to 1.13 m/s and in the Functional Gait Assessment from 20/30 to 27/30.Patient X's eye gaze compliance improved from a median of 43%(range 25e68%)to a median of 67%(58e83%).Discussion:This case study demonstrates that vestibular rehabilitation improved eye gaze compliance and functional outcomes in a person living with CANVAS.
文摘<span style="font-family:Verdana;"><strong>Background:</strong></span><span "=""><span style="font-family:Verdana;"> Ea</span><span><span style="font-family:Verdana;">rly intervention is beneficial for improving preterm infant motor and cognitive outcomes in early childhood;however, little is known about whether early intervention can influence a preterm infant’s participation. Additionally, many studies investigating the impact of early intervention for preterm infants have been conducted in large metropolitan centres, leaving preterm infants who reside i</span><span style="font-family:Verdana;">n regional areas underrepresented in the literature to date. Consequentia</span></span><span style="font-family:Verdana;">lly, it is not yet known whether there are service delivery models, such as using telehealth as an adjunct to face-to-face intervention, that might cater to the needs of preterm infants residing outside metropolitan centres. PreEMPT (Preterm infant Early intervention for Movement and Participation Trial) is a novel early physiotherapy intervention that has been designed to use a participation goal-directed intervention approach via a mixture of face-to-face clinic sessions and telehealth sessions to improve the motor and participation outcomes of preterm born infants. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This study aims to evaluate the feasibility of PreEMPT using an assessor-blinded, randomised controlled trial to compare PreEMPT to Usual Physiotherapy Care (UPC) for preterm infants residing in a regional Australian hospital catchment area. Twenty-six preterm infants (≤34 + 6 weeks gestational age) will be recruited prior to term corrected age from the special care nursery of a regional hospital. Following informed consent and baseline assessments, infants will be randomly allocated to receive either PreEMPT, a novel participation-focused early physiotherapy intervention delivered weekly for 14 forty-five-minute sessions alternating face-to-face sessions with telehealth into the infant’s home, or UPC, two - three physiotherapy sessions in the 4-month intervention period. Outcome measures relating to infant neuromotor development, motor performance, general development, and parental mental health and well-being will be assessed at 4-, 6- and 8-months corrected age. Feasibility will be evaluated by acceptability (parental satisfaction), demand and practicality (recruitment rate and telehealth session implementation), implementation (attendance at assessment and treatment sessions), and limited efficacy testing (comparing outcomes listed above for infants in PreEMPT and UPC). </span><b><span style="font-family:Verdana;">Discussion:</span></b><span style="font-family:Verdana;"> This study will be the first of its kind to use the participation of preterm infants in meaningful life situations as the foundation for intervention delivered via alternating face-to-face clinic sessions with telehealth into the home. The feasibility of this approach will be evaluated and used to inform future iterations of research about PreEMPT’s efficacy for improving preterm infant motor and participation outcomes.</span></span>
基金Supported by the National Human Genetic Resources Sharing Service Platform,No.PT-2024-0303Qingdao Medical and Health Research Guidance Project,No.2023-WJZD202.
文摘Colorectal cancer(CRC)ranks among the top causes of cancer-related fatalities globally.Recent progress in genomics,proteomics,and bioinformatics has greatly improved our comprehension of the molecular underpinnings of CRC,paving the way for targeted therapies and immunotherapies.Nonetheless,obstacles such as tumor heterogeneity and drug resistance persist,hindering advancements in treatment efficacy.In this context,the integration of artificial intelligence(AI)and organoid technology presents promising new avenues.AI can analyze genetic and clinical data to forecast disease risk,prognosis,and treatment responses,thereby expediting drug development and tailoring treatment plans.Organoids replicate the genetic traits and biological behaviors of tumors,acting as platforms for drug testing and the formulation of personalized treatment approaches.Despite notable strides in CRC research and treatment-from genetic insights to therapeutic innovations-numerous challenges endure,including the intricate tumor microen-vironment,tumor heterogeneity,adverse effects of immunotherapies,issues related to AI data quality and privacy,and the need for standardization in organoid culture.Future initiatives should concentrate on clarifying the pathogenesis of CRC,refining AI algorithms and organoid models,and creating more effective therapeutic strategies to alleviate the global impact of CRC.
文摘Background:Community-based first responders face high levels of workplace stressors that can pro-foundly impact their physical and mental health.Mindfulness-based interventions have shown promise in decreasing stress and increasing psychological resilience;however,implementation is difficult due to unpredictability of the job,department culture,and generational preferences.The objective of this qualitative study was to identify and enhance understanding of the specific needs and potential barriers and facilitators for the implementation of mindfulness-based programming for community-based first responders.Methods:A phenomenological qualitative study design was used to gain insights into the lived experiences of first responders and elicit perceptions regarding barriers and facilitators for engaging in mindfulness activities.During virtual semi-structured interviews,eleven career firefighters and emergency medical service(EMS)providers offered feedback relative to worksite mindfulness practices,and the use of a stress reduction smartphone application.The Consolidated Framework for Implementation Research was used to guide the analysis relative to barriers and facilitators of implementation success and sustainability.Results:First responders expressed openness to mindfulness-based interventions and a smartphone app that would provide stress reduction content,however,they were adamant that programming needed to be accessible and easily integrated into their workday.They also reinforced that organizational culture and leadership support for their health and well-being were overarching factors essential for implementation success.Conclusions:First responders were supportive of evidence-based mindfulness practices,optimally developed and/or facilitated by someone with intimate knowledge of their unique work environments and challenges.Organizational culture and leadership support were essential for implementation success and sustainability.
文摘BACKGROUND Proximal gastrectomy(PG)for gastric cancer requires a delicate balance between oncological radicality and postoperative quality of life to mitigate reflux complications.Although the Kamikawa anastomosis has gained attention for its theoretical anti-reflux advantages,robust clinical evidence remains limited.AIM To comprehensively evaluate the efficacy,safety,and nutritional outcomes of the Kamikawa anastomosis in PG,thereby addressing a critical gap in surgical decision-making.METHODS Following PRISMA guidelines,we systematically searched PubMed,Embase,and the Cochrane Library for studies on Kamikawa anastomosis after PG.Data were pooled using fixed-or random-effects models based on heterogeneity levels(I2 statistics).The risk of bias was evaluated using Risk of Bias in Non-randomized Studies of Interventions.The protocol was prospectively registered in PROSPERO.RESULTS Of 106 screened studies,20 involving 2291 patients were included.Most studies(85%)originated from Japan,with a mean patient age of 54-73 years and a male predominance(68.1%).Overall pooled incidence of 30-day postoperative complications was 9.9%[95%confidence interval(95%CI):6.8-12.9],with major complications(Clavien-Dindo grade≥III)occurring in 6.1%(95%CI:4.6-7.7).Anastomosis-related complications were observed in 7.2%of cases,comprising leakage 1.8%(95%CI:1.1-2.4),stenosis in 7.2%(95%CI:5.8-8.5),and bleeding in 0.7%(95%CI:0.1-1.2).Pooled incidence of reflux esophagitis was 4%(95%CI:2.7-5.3)for all LA grades at 12-month follow-up,with 28.3%(95%CI:14.7-41.9)of patients requiring regular proton pump inhibitor use.Operative outcomes demonstrated a pooled mean operative time of 349.5 minutes(95%CI:331-380),estimated blood loss of 351.5 mL(95%CI:264-495),and postoperative hospital stay of 12.3 days(95%CI:11.5-13.1).Nutritional outcomes revealed 11.4%(95%CI:10.6-12.2)body weight loss at one year.Comparative analyses showed equivalent safety profiles between the Kamikawa anastomosis and double-tract reconstruction but longer operative times(P<0.001)compared with total gastrectomy.CONCLUSION These findings underscore the clinical viability of the Kamikawa anastomosis following PG,demonstrating favorable anti-reflux efficacy,acceptable incidence of anastomotic strictures,and preservation of nutritional status.
基金supported by STI 2030-Major Projects(2022ZD0208903)the National Natural Science Foundation of China(62336007)+3 种基金the Natural Science Foundation of Shandong Province(ZR2024QH582)the Pioneer R&D Program of Zhejiang Province(2024C03001)the Starry Night Science Fund of Zhejiang University Shanghai Institute for Advanced Study(SN-ZJU-SIAS-002)the Fundamental Research Funds for the Central Universities(2024ZFJH01-01).
文摘Reach-to-grasp movements require integrating information on both object location and grip type,but how these elements are planned and to what extent they interact remains unclear.We designed a new experimental paradigm in which monkeys sequentially received reach and grasp cues with delays,requiring them to retain and integrate both cues to grasp the goal object with appropriate hand gestures.Neural activity in the dorsal premotor cortex(PMd)revealed that reach and grasp were similarly represented yet not independent.Upon receiving the second cue,the PMd continued encoding the first,but over half of the neurons displayed incongruent modulations:enhanced,attenuated,or even reversed.Population-level analysis showed significant changes in encoding structure,forming distinct neural patterns.Leveraging canonical correlation analysis,we identified a shared subspace preserving the initial cue’s encoding,contributed by both congruent and incongruent neurons.Together,these findings reveal a novel perspective on the interactive planning of reach and grasp within the PMd,providing insights into potential applications for brain–machine interfaces.
基金financial support from the National Natural Science Foundation of China(No.21705120)Natural Science Foundation of Shandong Province,China(Nos.ZR2023MB001,ZR2017LB016,ZR2022QB165)+1 种基金Special Fund for Taishan Scholar Project(Nos.tsqn202211231,tsqn202211233)Foundation of Yuandu Scholar and Science and Technology Development Plan Project of Weifang(No.2024JZ0012)。
文摘Liver diseases,particularly acute alcoholic liver injury(AALI),drug-induced liver injury(DILI),and hepatocellular carcinoma(HCC),have become global public health issues.Glutathione(GSH),as an important antioxidant,plays a crucial role in the liver,and its changes are closely associated with liver injury and the development of liver cancer.Therefore,accurately monitoring GSH variations is critical for understanding liver injury mechanisms,early diagnosis,and treatment evaluation.However,traditional detection methods suffer from insufficient sensitivity and selectivity.To address these challenges,we developed an innovative DR-Au^(3+)/DR-Pd^(2+)complex probe that can rapidly and sensitively detect GSH through near-infrared(NIR)fluorescence changes.This probe,with the optimal excitation and emission wavelengths of the probe both located in the NIR region,exhibits excellent selectivity and liver-targeting ability,overcoming the imprecision localization problems of traditional methods.In the AALI and DILI models,the optimized DR-Au^(3+)probe enables real-time monitoring of GSH level fluctuations,providing a powerful tool for early diagnosis of liver injury and dynamic evaluation of therapeutic efficacy.In the DILI and HCC models,the DR-Au^(3+)probe enables visualization and quantitative monitoring of the ferroptosis process,offering new perspectives and approaches for targeted therapy research.The DR-Au^(3+)probe we developed pioneers innovative strategies for establishing accurate diagnostic protocols and individualized therapeutic regimens in hepatic injury and hepatocellular carcinoma management.
基金support by Shandong Provincial Natural Science Foundation(Grant No ZR2024QH150,ZR2024YQ068)Taishan Scholars Program of Shandong Province(Grant No tsqn202306272)+5 种基金National Natural Science Foundation of China(Grant No 82302388)National Key Research and Development Project of China(Grant No 2023YFFO715101)Qingdao Natural Science Foundation(Grant No 23-2-1-132-zyyd-jch)the Leading Project of Science and Technology of Yantai Development Zone(Grant No 2021RC016)National Key RD Program of China(2021YFF1201100)Hubei Key Laboratory of Biomass Fibers&Eco-Dyeing&Finishing(Wuhan Textile University,Grant No STRZ202322).
文摘Efficient reconstruction of severe cutaneous wounds necessitates the orchestration of effective cell-mediated matrix remodeling and robust protection against microbial invasion.Herein,we engineered a near-infrared light(NIR)-stimulated,thermo-responsive bilayer system based on a drug-loaded hydrogel with a thermal-responsive temperature of~42℃ as the matrix layer and an antibacterial nanofibrous mat as the top layer.The matrix layer integrates basic fibroblast growth factor(bFGF)-loaded thermosensitive gelatin(Gel)hydrogel with polydopamine-Cu^(2+)coated short nanofibers(P@SF).Upon NIR exposure,P@SF elicits a photothermal effect,causing a rapid increase in temperature by 13.4℃ within 1 min at a power density of 0.75 W/cm^(2),which triggers the gel-sol transition of Gel and controls the release of bFGF.This,in turn,enhances fibroblast and endothelial cells ingrowth into the hydrogel,fostering cell functionalization and matrix remodeling.The top layer consists of poly(L-lactide-co-caprolactone)nanofibers functionalized with lysine-doped polydopamine and poly-l-lysine.It possesses antibacterial efficacy by isolating,controlling(76.23%for E.coli and 89.16%for S.aureus),and eliminating bacteria upon NIR activation.In rat skin wound models,this NIR-responsive smart bilayer system prevents S.aureus-mediated bacterial infection(indicative of reduced IL-6 expression),regulates CD31-positive neovascularization,and facilitates collagen remodeling for skin regeneration.In summary,this study introduces a novel strategy,inspired by the centralization of authority,for developing a smart thermo-responsive system with promising potential for the effective reconstruction of severe cutaneous wounds.
基金Supported by the Shandong Provincial Natural Science Foundation of China,No.ZR2023QH015Qingdao Municipal Natural Science Foundation of China,No.23-2-1-134-zyyd-jch.
文摘BACKGROUND Protein-losing enteropathy(PLE)is a rare cause of hypoalbuminemia that can be attributed to intestinal lymphangiectasia.Patients with Noonan syndrome may present with disorder of lymph vessel formation.However,PLE is rarely reported with Noonan syndrome.CASE SUMMARY A 15-year-old female was hospitalized multiple times for recurrent edema and diarrhea secondary to hypoalbuminemia.Additional manifestations included a ventricular septal defect at birth,intermuscular hemangioma,slightly wide interocular and intermammary distances,and absence of the distal phalanx of the left little finger since birth.Abdominal computed tomography revealed cavernous transformation of the portal vein,and liver biopsy indicated“porto-sinusoidal vascular disease”.Whole exome and Sanger sequencing revealed a heterozygous mutation(exon9:C.850C>T:P.R284C)in leucine zipper-like transcription regulator 1,suggesting Noonan syndrome type 10.Further examinations revealed thoracic duct dysplasia and intestinal lymphangiectasia causing PLE in this patient.A multidisciplinary team decided to address thoracic duct dysplasia with outlet obstruction.Approximately two years after the microsurgical relief of the thoracic duct outlet obstruction,the patient achieved persistent normal serum albumin level without edema or diarrhea.Furthermore,the relevant literatures on Noonan syndrome and PLE were reviewed.CONCLUSION Herein,we reported the first case of PLE associated with Noonan syndrome caused by a rare genetic mutation in leucine zipper-like transcription regulator 1(c.850C>T:P.R284C)with newly reported manifestations.This case presented the successful treatment of clinical hypoalbuminemia attributed to thoracic duct dysplasia,intestinal lymphangiectasia and PLE.
基金Shandong Provincial Natural Science Foundation,Grant/Award Number:ZR2022MH211the Key Program of Shandong Provincial Natural Science Foundation,Grant/Award Number:ZR2020KE018National Natural Science Foundation of China,Grant/Award Number:52003068。
文摘Background:Scientific animal models are indispensable for studying trauma repair.This work aimed at establishing a more scientific rat trauma model by studying different rat trauma models caused by different trauma numbers,locations,and trauma attachment tension unloaders and rat age.Methods:A four-trauma self-upper,lower,left and right control model;a two-trauma self-trauma bare and ring control model;and a young and old rat trauma model were created to evaluate the condition of these traumas.Results:In the four-trauma self-control model,the healing status of the upper proximal cephalic trauma was better than that of the lower proximal caudal trauma,whereas there was no significant difference between the left and right trauma.The healing rate and postwound condition of the trauma with a ring control in the two-trauma model were better than those of the bare side.The healing speed of the old rats was slower,and the amount of extracellular matrix in the subcutaneous tissue after healing was significantly lower than that of the young rats.Conclusion:The double trauma with a ring is a more scientific and reasonable experimental model.There is a significant difference between young and old rats in the wound healing process.Therefore,the appropriate age of the rats should be selected according to the main age range of the patients with similar conditions in the clinical setting being mimicked.
基金supported by Guangdong Basic and Applied Basic Research Foundation(No.2024A1515012810).
文摘Motion intention recognition is considered the key technology for enhancing the training effectiveness of upper limb rehabilitation robots for stroke patients,but traditional recognition systems are difficult to simultaneously balance real-time performance and reliability.To achieve real-time and accurate upper limb motion intention recognition,a multi-modal fusion method based on surface electromyography(sEMG)signals and arrayed flexible thin-film pressure(AFTFP)sensors was proposed.Through experimental tests on 10 healthy subjects(5 males and 5 females,age 23±2 years),sEMG signals and human-machine interaction force(HMIF)signals were collected during elbow flexion,extension,and shoulder internal and external rotation.The AFTFP signals based on dynamic calibration compensation and the sEMG signals were processed for feature extraction and fusion,and the recognition performance of single signals and fused signals was compared using a support vector machine(SVM).The experimental results showed that the sEMG signals consistently appeared 175±25 ms earlier than the HMIF signals(p<0.01,paired t-test).In offline conditions,the recognition accuracy of the fused signals exceeded 99.77%across different time windows.Under a 0.1 s time window,the real-time recognition accuracy of the fused signals was 14.1%higher than that of the single sEMG signal,and the system’s end-to-end delay was reduced to less than 100 ms.The AFTFP sensor is applied to motion intention recognition for the first time.And its low-cost,high-density array design provided an innovative solution for rehabilitation robots.The findings demonstrate that the AFTFP sensor adopted in this study effectively enhances intention recognition performance.The fusion of its output HMIF signals with sEMG signals combines the advantages of both modalities,enabling real-time and accurate motion intention recognition.This provides efficient command output for human-machine interaction in scenarios such as stroke rehabilitation.
基金supported by Shenzhen Educational Research Funding(zdzb2014)Shenzhen Science and Technology Innovation Commission Foundation(202307313000096)+4 种基金Social Science Foundation from China’s Ministry of Education(23YJA880093)China Postdoctoral Science Foundation(2022M711174)National Center for Mental Health Foundation(Z014),Research Excellence Scholarships of Shenzhen University(ZYZD2305)Research Funding for Society of Sport Science(PT2023030)Natural Science Foundation of Shenzhen University(000311).
文摘Background:Taking actions to maintain a healthy lifestyle,including regular engagement in physical activity(PA)and reducing sedentary behavior(SB),may protect against the development of internalizing problems among healthy youth.However,it remains unclear whether such associations exist among youth with chronic pain who often report symptoms of depression and anxiety.To this end,we aimed to investigate the associations between independent and combined PA and/or SB patterns with indicators of internalizing problems in this vulnerable population.Methods:Data used in this cross-sectional study were retrieved from the U.S.National Survey of Children’s Health for the years 2021-2022.Specifically,caregiver proxy reports on sociodemgraphic factors and lifestyle behaviors of 4735 U.S.children and adolescents(referring to youth)aged 6-17 years were collected.We examined independent and combined patterns of PA and SB as exposures,with internalizing problems serving as outcomes of interest.Logistic regressions were used to examine the independent and combined associations of PA and/or SB patterns with anxiety and depression symptoms among youth with chronic pain while adjusting for covariates including age,sex,ethnicity,primary caregivers’education level,overweight status,and household federal poverty level.Results:Overall,our results indicated that PA was negatively associated with anxiety and depressive symptoms.Specifically,youth with chronic pain who engaged in at least 60-minute PA for 1-3 days,4-6 days,or every day reported significantly lower likelihood of experiencing symptoms of anxiety(OR=0.71,95%CI:0.60-0.84;OR=0.44,95%CI:0.36-0.53;OR=0.50,95%CI:0.40-0.63,respectively;all p-value<0.001)and depression(OR=0.63,95%CI:0.53-0.75;OR=0.38,95%CI:0.31-0.47;OR=0.46,95%CI:0.36-0.59,respectively;all p-value<0.001)symptoms compared to those with 0 days.Conversely,SB(operationalized via the proxy screen time)was positively associated with anxiety and depression symptoms.Youth with chronic pain who reported 4 or more hours of daily screen time had significantly higher odds of experiencing symptoms of anxiety(OR=2.17,95%CI:1.52-3.09,p<0.001)and depression(OR=2.30,95%CI:1.48-3.59,p<0.001).Furthermore,youth with chronic pain who engaged in higher PA levels and reported lower SB levels had a lower likelihood of experiencing symptoms of anxiety(OR=0.68,95%CI:0.52-0.87,p=0.003)and depression(OR=0.49,95%CI:0.34-0.70,p<0.001)symptoms compared to those with lower PA levels and higher SB levels.Conclusions:Higher PA levels and lower SB levels were associated with a reduced likelihood of developing anxiety and depression symptoms,which are indicative of internalizing problems,among youth with chronic pain.Future public health actions in this vulnerable population should prioritize intervention programs that promote PA engagement to reduce SB levels.
基金supported by the Shandong Second Medical University Overseas Visiting Scholar Programthe National Medical Research Council of Singapore (grant numbers NMRC/TA/0053/2016 and NMRC/CSA/INV/0009/2022)
文摘INTRODUCTION With the expansion of the ageing population,cognitive decline has become an increas-ingly pressing challenge.1 As life expectancy increases,its socioeconomic burden is also increasing,highlighting the urgent need for effective interventions.Numerous studies suggest that specific dietary patterns and nutritional interventions may help mitigate cognitive decline associated with ageing.
基金financial support from the general electric (GE) healthcareAustralian Research Council Discovery Project (DP200101476)+5 种基金in parts by National Institutes of Health (NIH) grants (R01 AR077604, R01 EB002524, R01 AR079431, P41 EB02706)Stanford Graduate FellowshipThe University of Queensland Graduate ScholarshipNational Health and Medical Research Council of Australia Fellowship (#1194937)Wu Tsai Human Performance Alliance at Stanford Universitythe Joe and Clara Tsai Foundation
文摘Background While Nordic hamstring exercise(NHE)training has been shown to reduce hamstring strains,the muscle-specific adaptations to NHE across the 4 hamstrings remain unclear.This study investigates architectural and microstructural adaptations of the biceps femoris short head(BFsh),biceps femoris long head(BFlh),semitendinosus(ST),and semimembranosus(SM)in response to an NHE intervention.Methods Eleven subjects completed 9 weeks of supervised NHE training followed by 3 weeks of detraining.Magnetic resonance imaging was performed at pre-training,post-training,and detraining to assess architectural(volume,fiber tract length,and fiber tract angle)and microstructural(axial(AD),mean(MD),radial(RD)diffusivities,and fractional anisotropy(FA))parameters of the 4 hamstrings.Results NHE training induced significant but non-uniform hamstring muscle hypertrophy(BFsh:22%,BFlh:9%,ST:26%,SM:6%)and fiber tract length increase(BFsh:11%,BFlh:7%,ST:18%,SM:10%).AD(5%),MD(4%),and RD(5%)showed significant increases,but fiber tract angle and FA remained unchanged.After detraining,only ST showed a significant reduction(8%)in volume,which remained higher than the pre-training value.While fiber tract lengths returned to baseline,AD,MD,and RD remained higher than pre-training levels for all hamstrings.Conclusion The 9-week NHE training substantially increased hamstring muscle volume with greater hypertrophy in ST and BFsh.Hypertrophy was accompanied by increases in fiber tract lengths and cross-sections(increased RD).After 3 weeks of detraining,fiber tract length gains across all hamstrings declined,emphasizing the importance of sustained training to maintain all the protective adaptations.
