Comparative Effectiveness Research Articles

Cognitive bias modification for social anxiety: protocol for a living systematic review of human studies and meta-analysis

Background Social anxiety is a heightened fear and discomfort in social situations which can be experienced in varying degrees of severity. Cases of elevated distress and impaired functioning and quality of life can lead to a clinical diagnosis of social anxiety disorder. Altering cognitive biases associated with social anxiety has been suggested as potentially beneficial; however, little is known about the comparative effectiveness of such interventions. The aim of this living systematic review is to examine the efficacy of cognitive bias modification for reducing social anxiety, including in people who have not been diagnosed with the disorder. Methods We will search multiple electronic databases for randomised controlled trials evaluating the efficacy of cognitive bias modification for people diagnosed with social anxiety and people exposed to a simulated social stressor. The primary outcome will be change in social anxiety related symptoms; secondary outcomes will be changes in social functioning and quality of life and adverse events. Study selection, data extraction and risk of bias assessment will be done by at least two reviewers using pre-defined tools. We will synthesise data from people with social anxiety diagnosis and those subjected to a simulated social stressor separately using random effects meta-analyses. Heterogeneity will be evaluated by investigating characteristics of included studies. We will appraise the strength of the evidence for each outcome by reviewing the overall association, internal and external validity, and reporting biases. Where data allows, we will triangulate the evidence from both sources with a multidisciplinary group of experts. The review will begin in living mode and the database search will be rerun every three months to identify and integrate potential new evidence. We will co-produce this review with members of a global lived experience advisory board. This protocol was registered with PROSPERO (CRD42024601380) on 15.10.2024.

Comparative Efficacy of Different Pharmacological Treatments for Pityriasis Rosea: A Network Meta-Analysis

Background/Objectives: Pityriasis rosea (PR) is a self-limiting exanthematous disease associated with the endogenous reactivation of human herpesviruses (HHV)-6 and HHV-7. Classically, the lesions gradually resolve, leaving no sequelae. Therefore, the best treatment is reassuring the patient and suggesting a resting period. However, atypical PR cases characterized by extensive, persistent lesions and systemic symptoms may impact the patient’s quality of life, and, therefore, a treatment can be prescribed. There is limited evidence on the comparative effectiveness of pharmacological treatments for PR; therefore, we performed a network meta-analysis to compare these interventions. Methods: Overall, 12 randomized control trials (RCTs) were identified. The outcomes were itch resolution and rash improvement. Results were expressed as risk ratio (RR) and 95% confidence interval (CI). We also calculated the relative ranking of the interventions for achieving the aforementioned outcomes as their surface under the cumulative ranking (SUCRA). Results: On network meta-analysis, only oral steroids and the combination of oral steroids+antihistamine resulted significantly superior to the placebo in terms of itch resolution (RR 0.44, CI 0.27–0.72 and RR 0.47, CI 0.22–0.99). Oral steroids resulted in the best treatment (SUCRA 0.90) for itch resolution. In terms of rash improvement, only acyclovir and erythromycin resulted significantly superior to placebo (RR 2.55, CI 1.81–3.58; and RR 1.69, CI 1.23–2.33), and acyclovir outperformed all the other tested interventions. Consequently, acyclovir ranked as the best intervention (SUCRA score 0.92). Conclusions: Acyclovir represents the best option for patients with PR that have extensive, persistent lesions or systemic symptoms. Steroids and antihistamines seemed the best treatment for itch resolution.

Robotic Versus Thoracoscopic Minimally Invasive Mitral Valve Surgery: A Systematic Review and Meta-Analysis of Matched Studies.

Mitral regurgitation is the most prevalent form of valvular heart disease, impacting over 24 million people globally. Robotic and thoracoscopic minimally invasive mitral valve repair (MIMR) techniques have emerged as viable alternatives to traditional open-heart surgery. However, the comparative effectiveness and safety of these 2 approaches remain underexplored. This systematic review and meta-analysis, conducted according to Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, aimed to compare robotic and thoracoscopic MIMR outcomes. A literature search was performed across PubMed, Scopus, and Embase databases to identify studies comparing these 2 surgical techniques. Eligible studies included randomized controlled trials and cohort studies. Six propensity score-matched studies and 1 retrospective cohort study, involving 11,823 patients, were included, with 5851 undergoing robotic mitral valve repair and 5972 receiving thoracoscopic MIMR. No significant differences were found in perioperative mortality [risk ratio (RR): 0.97, 95% confidence interval (CI): 0.65-1.45] or pump/clamp times. Robotic surgery was associated with longer operative times (mean difference: 33.01 minutes) and higher intraoperative transfusion rates (RR: 1.53, 95% CI: 1.07-2.18), but a lower risk of atrial fibrillation (RR: 0.89, 95% CI: 0.83-0.95). In conclusion, robotic and thoracoscopic MIMR show comparable mortality and overall safety profiles. However, robotic surgery may require longer operative times and increased transfusion needs, while reducing the risk of atrial fibrillation. Further high-quality, randomized studies are warranted to validate these findings.

Transcranial Direct Current Stimulation over the Posterior Parietal Cortex Increases Non-target Retrieval during Visual Working Memory.

Visual working memory (VWM) requires precise feature binding. Previous studies have revealed a close relationship between the posterior parietal cortex (PPC) and feature binding during VWM, this study further examined their causal relationship through three transcranial direct current stimulation (tDCS) experiments. In Experiment 1 (N = 57), participants underwent three sessions of tDCS separately, including PPC stimulation, occipital cortex stimulation, and sham stimulation, and completed delayed estimation tasks for orientations before and after stimulation. Results showed that tDCS over PPC selectively prolonged recall response time (RT) and increased the probability of non-target responses (a.k.a. failure of feature binding, pNT). In Experiment 2 (N = 29), combining metacognition estimation, we further investigated whether the effects of PPC stimulation were attributed to mis-binding (i.e., participants self-reported "remembered" in non-target responses) or informed guessing trials (participants self-reported "forgotten" in non-target responses). We replicated the main findings in Experiment 1, and observed greater tDCS effects of PPC on RT in informed guessing trials while comparable effects on pNT in these two types of trials. In Experiment 3 (N = 28), we then examined whether the tDCS effects over PPC specifically influenced the memory retrieval process by using a change detection task. We found that PPC stimulation did not influence the recognition RT or accuracy. Together, this study provided direct causal evidence supporting the specific involvement of PPC in feature binding during VWM retrieval, from both aspects of speed and response preference, expanding our understanding of the neural basis of feature binding in VWM.Significance Statement Visual working memory (VWM) enables humans to temporarily store and process visual information, which requires accurate binding of items to their unique context. Accumulating studies posited that the posterior parietal cortex (PPC) is closely related to this binding process, the current study further examined their causal relationship. Through three strictly within-subject well-designed non-invasive neural stimulation experiments, we found that PPC stimulation selectively increased response time (RT) and binding error during VWM. Moreover, we found these changes were modulated by individual metacognition and only occurred during memory recall instead of recognition. Together, our results provided strong evidence that PPC is causally involved in the binding process during visual working memory retrieval.

Clinical Effectiveness and Safety of Midazolam Compared With Lorazepam for Control of Seizures in Adults

What Is the Issue? The emergency treatment of prolonged seizures or status epilepticus is required to be rapid and efficient to prevent permanent brain damage or death. Benzodiazepines, such as midazolam, lorazepam, diazepam, and clonazepam, are established as first-line treatment medications for acute treatments of seizures. Various administration routes of delivery for these drugs have become available, but the comparative clinical effectiveness and safety among administration routes are still unclear. Decision-makers are interested in whether the current use of intramuscular (IM) midazolam for treatment of seizures by paramedics in a prehospital environment can be switched to IV lorazepam as normally used by nurses and physicians in clinic settings. What Did We Do? We identified and summarized the literature on the evidence of the clinical effectiveness and safety of midazolam compared to lorazepam in adults to control seizures. We searched key resources, including journal citation databases, and conducted a focused internet search for relevant evidence published since 2019. One reviewer screened citations for inclusion based on predefined criteria, critically appraised the included studies, and narratively summarized the findings. What Did We Find? We identified 1 systematic review (SR) that included 4 randomized controlled trials (RCTs), only 1 was relevant to this review. This double-blind RCT determined the efficacy of IM midazolam as noninferior to IV lorazepam for treatment of seizures by paramedics in a mixed population of adults (89%) and children (11%). The authors of the SR conducted a subanalysis of a dataset of participant-level data and showed that IM midazolam was as effective and safe as IV lorazepam in adult patients for prehospital seizure cessation. The findings of the adult population were similar to those of the whole randomized population of both adults and children. What Does This Mean? With the shorter time required to administration of midazolam by the IM route compared to administration of lorazepam by the IV route, and the comparable efficacy and safety between the 2 active treatments, the use of IM midazolam may be a better option in the prehospital environment when IV access in patients with seizures is not readily established. Switching of IM midazolam to IV lorazepam for treatment of seizures by paramedics may not be practical.

Comparative effects of tea and coffee drinking on body weight in adults: a systematic review and network meta-analysis of randomised trials.

We aimed at quantifying the effects of different tea and coffee on weight loss in adults. We searched PubMed, Scopus, CENTRAL and grey literature sources to July 2024. The study excluded cross-over trials without washout period, those in critically ill patients, pregnant or breast-feeding women, multicomponent interventions and active control groups with tea or coffee. A random-effects network meta-analysis with a Bayesian framework was performed to calculate the mean difference (MD) and 95 % credible intervals (CrIs). The certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach, and risk of bias was assessed using Cochrane tool. Twenty-two randomised controlled trials with 1710 participants (average intervention duration = 10 weeks) were included. Green tea was effective for weight loss compared with placebo (MD: −1·23 kg, 95 % CrI: −2·45, −0·02; low certainty evidence) or water (MD: −1·61 kg, 95 % CrI: −2·90, −0·35; very low certainty evidence), while other beverages (coffee, decaffeinated coffee, green coffee, black tea and sour tea) were not. Green tea was effective for weight loss compared with water in sensitivity analysis of healthy individuals (MD: −3·31 kg, 95 % CrI: −5·83, −1·04). Based on very low to low certainty evidence, green tea drinking may result in a small weight loss in adults. This study mainly focused on weight loss effects of green tea and coffee, with limited data on other teas. Only five trials had longer intervention durations, suggesting future research on long-term effects. Most trials had high bias risk and low certainty, requiring more high-quality trials.

Effects of dietary proteins on cognitive performance and brain vascular function in adults: a systematic review of randomised controlled trials.

The incidence of cognitive decline is rising, leading to increased attention on the preventive role of healthy foods on brain function. Previous reviews including primarily observational studies suggested that dietary proteins may improve cognitive performance, but evidence from individual randomised controlled trials (RCT) is less consistent. Therefore, this systematic review examined the long-term effects of dietary proteins from RCT, considering both their amount and type, on cognitive performance (psychomotor speed and attention, executive function, memory and global cognition). Alterations in cerebral blood flow (CBF) - a validated brain vascular function marker - were also considered. A total of 4747 studies were identified through a systematic search, resulting in twenty-three included papers reporting effects on cognitive performance (n = 23) and CBF (n = 3). Improvements were observed in three out of the nine studies that evaluated psychomotor speed which compared a dietary protein intervention with a non-protein or lower-protein control. Of the six beneficial observations on working memory (n = 12), declarative memory (n = 10) and visuospatial memory (n = 10), five were nut interventions from three different trials. Limited studies focusing on global cognition suggested that specific target populations, namely subacute stroke or dementia, may benefit more than healthy individuals from increased dietary protein intake. From the three studies involving CBF, improvements in regional blood flow were associated with most cognitive performance outcomes. The comparative effects of different protein types warrant further investigation. Overall, this review encourages additional research into protein-rich foods or supplements which could potentially prevent or mitigate cognitive decline.

A study of the comparative effectiveness of dual antiplatelet therapy and a combination of acetylsalicylic acid with colchicine in patients in the acute period of “minor” ischemic atherothrombotic stroke during hospitalization. Interim analysis of data from the «COLCHIDA» study

Influence on inflammation is currently becoming a priority target for the prevention of recurrent atherothrombotic events, including stroke. In 2022, we planned the KOLCHIDA study, a two-center, prospective, randomized, open-label, controlled clinical trial with endpoint assessment (ClinicalTrials.gov identifier: NCT06102720). The purpose of this study is to conduct a comparative assessment of the clinical effectiveness of dual antiplatelet therapy with acetylsalicylic acid (ASA) and clopidogrel and the combination of ASA with colchicine in patients in the acute period of “minor” ischemic atherothrombotic stroke. The purpose of this publication is to present the basic concept of the protocol, its design and the first intermediate results. Material and methods. The intervention consisted of colchicine 0.5 mg/day in addition to ASA versus dual antiplatelet therapy (DAPT) in patients with non-severe ischemic stroke. 31 patients were included in the colchicine and ASA group, and 34 patients were included in the DAPT group. Results. In the comparison group, 7 (20.6%) recurrent non-fatal strokes were recorded, in contrast to the colchicine group, where acute vascular events were recorded in only two patients (6.5%) [RRR 2.2, NNT = 7, χ2 = 2, 9, p = 0.09]. There were no clinically significant bleeding or other adverse events in both groups. Conclusion. Interim results of the study indicate possible confirmation of the hypothesis that anti-inflammatory therapy with low doses of colchicine in combination with standard therapy is not inferior to the combination of ASA and clopidogrel, and perhaps more effectively reduces the number of early neurological deteriorations and recurrent ischemic strokes in patients in the acute period of mild atherothrombotic stroke with equal security profile.

Comparative efficacy of interpersonal psychotherapy and antidepressant medication for adult depression: a systematic review and individual participant data meta-analysis.

Interpersonal psychotherapy (IPT) and antidepressant medications are both first-line interventions for adult depression, but their relative efficacy in the long term and on outcome measures other than depressive symptomatology is unknown. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional meta-analyses. This IPD meta-analysis compared the efficacy of IPT and antidepressants on various outcomes at post-treatment and follow-up (PROSPERO: CRD42020219891). A systematic literature search conducted May 1st, 2023 identified randomized trials comparing IPT and antidepressants in acute-phase treatment of adults with depression. Anonymized IPD were requested and analyzed using mixed-effects models. The prespecified primary outcome was post-treatment depression symptom severity. Secondary outcomes were all post-treatment and follow-up measures assessed in at least two studies. IPD were obtained from 9 of 15 studies identified (N = 1536/1948, 78.9%). No significant comparative treatment effects were found on post-treatment measures of depression (d = 0.088, p = 0.103, N = 1530) and social functioning (d = 0.026, p = 0.624, N = 1213). In smaller samples, antidepressants performed slightly better than IPT on post-treatment measures of general psychopathology (d = 0.276, p = 0.023, N = 307) and dysfunctional attitudes (d = 0.249, p = 0.029, N = 231), but not on any other secondary outcomes, nor at follow-up. This IPD meta-analysis is the first to examine the acute and longer-term efficacy of IPT v. antidepressants on a broad range of outcomes. Depression treatment trials should routinely include multiple outcome measures and follow-up assessments.

Rigid versus flexible bronchoscopy in interventional pulmonology: perspective from the master clinicians.

The review explores the evolving roles and comparative effectiveness of rigid versus flexible bronchoscopy in interventional pulmonology. This topic is particularly timely due to recent technological advancements and the growing body of literature highlighting the strengths and limitations of each technique. Recent literature reveals significant advancements in rigid and flexible bronchoscopy, with studies comparing their efficacy, safety profiles, and clinical outcomes. Key themes include improved diagnostic and therapeutic capabilities, procedural innovations, and patient-centered outcomes. While rigid and flexible bronchoscopies have distinct advantages, their complementary use can enhance patient care. Future research should focus on developing minimally invasive, high-precision bronchoscopic tools, comparative studies to inform evidence-based practice, exploring hybrid approaches that combine the strengths of both techniques, and enhancing patient-centered outcomes through improved procedural protocols, education, and technologies.

Hypoxic Responses in Periodontal Tissues: Influence of Smoking and Periodontitis.

This study aimed to investigate the hypoxic changes in periodontal tissues resulting from smoking and periodontitis by assessing levels of hypoxia-inducible factors (HIF-1α, HIF-2α, HIF-3α) and vascular endothelial growth factor (VEGF) in gingival crevicular fluid (GCF). The study comprised 22 periodontally healthy non-smokers (Group H), 22 periodontally healthy smokers (Group HS), 22 non-smokers with periodontitis (Group P) and 22 smokers with periodontitis (Group PS). Clinical periodontal parameters were documented, and GCF samples were collected and analysed using enzyme-linked immunosorbent assay (ELISA). Significantly elevated levels of HIF-1α, HIF-3α and VEGF were observed in Groups HS, P and PS compared to Group H (p < 0.05). Moreover, higher HIF-2α levels were detected in the Groups HS and P compared to Group H (p < 0.05). Significant correlations were detected between all evaluated hypoxia biomarkers in the Group P (p < 0.05) except HIF-2α and HIF-3α. However, in the PS group, significant correlation appeared only between HIF-1α and HIF-2α (p < 0.05). Our findings indicate that smoking and periodontitis induce comparable hypoxic effects in periodontal tissues, as evidenced by the evaluated biomarkers. Further research is warranted to gain a deeper understanding of the mechanisms underlying hypoxia in periodontal tissues.

Comparative effectiveness of cognitive behavioural therapy, modafinil, and their combination for treating fatigue in multiple sclerosis (COMBO-MS): a randomised, statistician-blinded, parallel-arm trial

Fatigue is one of the most disabling symptoms reported by people with multiple sclerosis. Although behavioural and pharmacological interventions might be partly beneficial, their combined effects have not been evaluated for multiple sclerosis fatigue, or examined with sufficient consideration of characteristics that might affect treatment response. In this comparative effectiveness research trial, we compared the effectiveness of cognitive behavioural therapy (CBT), modafinil, and their combination for treating multiple sclerosis fatigue. This randomised, analyst-blinded, parallel-arm, comparative effectiveness trial was done at two universities in the USA. Adults (aged ≥18 years) with multiple sclerosis and problematic fatigue (Fatigue Severity Scale [FSS] score ≥4) were randomly assigned (1:1:1), using a web-based treatment assignment system with minimisation, to receive CBT, modafinil, or both for 12 weeks. Statisticians were masked to group assignment, but participants, study neurologists, CBT interventionalists, and coordinators were not masked to treatment assignment. The primary outcome was the change in Modified Fatigue Impact Scale (MFIS) from baseline to 12 weeks, assessed using multiple linear regression, adjusted for age, sex, study site, anxiety, pain, baselines MFIS score, and physical activity. Analyses were done by intent to treat. The trial was registered with clinicaltrials.gov, NCT03621761, and is completed. Between Nov 15, 2018, and June 2, 2021, 336 participants were randomly assigned treatment (114 assigned to CBT, 114 assigned to modafinil, and 108 assigned to combination therapy). At 12 weeks, CBT (n=103), modafinil (n=107), and combination therapy (n=102) were associated with clinically meaningful within-group MFIS reductions of 15·20 (SD 11·90), 16·90 (15·90), and 17·30 (16·20) points, respectively. Change in MFIS scores from baseline to 12 weeks did not differ between groups: relative to combination therapy, the adjusted total mean difference in MFIS change score was 1·88 (95% CI -2·21 to 5·96) for CBT and 1·20 (-2·83 to 5·23) for modafinil. Most common adverse events for modafinil-containing treatment groups included insomnia (eight [7%] for modafinil and eight [7%] for combination therapy) and anxiety (three [3%] for modafinil and nine [8%] for combination therapy). Modafinil, CBT, and combination therapy were associated with similar reductions in the effects of multiple sclerosis fatigue at 12 weeks. Combination therapy was not associated with augmented improvement compared with the individual interventions. Further research is needed to determine whether effects of these interventions on multiple sclerosis-related fatigue is influenced by sleep hygiene and sleepiness. No serious adverse events related to the study drug were encountered. Patient-Centered Outcomes Research Institute and National Multiple Sclerosis Society.

Investigation of the characteristics of the heaving lock-in region of the 10:1 π-shaped section

To gain a comprehensive understanding of the intrinsic characteristics of the lock-in region of the π-shaped section, a study was conducted to investigate the influence of the Angle of Attack (AOA), damping ratio, and mass ratio on the characteristics of the two lock-in regions using a 1:50 segment model test. The Proper Orthogonal Decomposition (POD) method was employed to analyze the characteristics of the two lock-in regions, and the flow field difference between the two lock-in regions was analyzed using Computational Fluid Dynamics (CFD). The findings indicate that both the Angle of Attack (AOA) and mass ratio have comparable effects on the lock-in region. However, it is noteworthy that the AOA appears to exert a more pronounced influence on the second lock-in region, whereas the damping ratio predominantly impacts the amplitude of the lock-in region. The analysis of the distribution and jumping degree of the surface time-averaged pressure enables us to infer the key-action zone number and action position of vortices present around the given section. In the two-lock-in region, there exist two different distribution forms for the energy ratio of POD modes. The first lock-in region is primarily affected by the Karman vortex street phenomenon, whereas the second lock-in region is mainly influenced by the long tail vortex shedding.

Comparative study of the neuroprotective potential of semaglutide injectable preparations in experimental ischemic stroke

Introduction. Stroke remains one of the major causes of death in type diabetes mellitus (DM). Injectable form of glucagon-like peptide-1 receptor agonist semaglutide, Ozempic® decreases the stroke risk. In Russia there appeared a biosimilar Semavic® but its effects on the brain are not yet studied.Aim. To compare neuroprotective properties of Semavic® and Ozempic® while used before ischemic stroke in rats without DM.Materials and methods. The study was conducted in male Wistar rats that were divided into the following groups: “Control” (n = 10) – 0.9% NaCl, “MET” (n = 9) – metformin 200 mg/kg once daily per os, “Ozempic” (n = 10) – Ozempic® 0.012 mg/kg s.c. once daily, “Semavic” (n = 9) – Semavic® 0.012 mg/kg s.c. once daily. After 7 days ischemic stroke was modelled, after 48 hour of reperfusion neurological deficit and brain damage volume were evaluated. Glycemia was measured on the 3rd, 7th days as well as during and after ischemia.Results. None of the study drugs caused hypoglycemia including in poststroke period. Neurological deficit in “MET” group did not differ from that in the “Control” (11.00 [6.50; 12.50] and 10.0 [6.25; 12.00] scores). Both semaglutide drugs caused comparable improvement in neurological status (14.00 [12.00; 18.00] and 14.00 [11.00; 18.00] scores in “Ozempic” and “Semavic” groups). Brain necrosis volume in “Control” group was 16.60 [13.40; 28.58] %. All the study drugs had infarct-limiting effect but brain damage volume in “Ozempic” (6.00 [4.32; 8.44] %) and “Semavic” (7.69 [2.99; 11.33] %) was smaller than in “MET” group (13.07 [8.67; 29.94] %). There were no differences between semaglutide drugs.Conclusions. Biosimilar Semavic® and original Ozempic® demonstrate comparable neuroprotective effect while used in animals without DM prior to ischemic stroke modelling. This protective effect is not due to the drugs’ influence on glycemic profile.

Infralimbic-basolateral amygdala circuit associated with depression-like not anxiety-like behaviors induced by chronic neuropathic pain and the antidepressant effects of electroacupuncture

Chronic pain, such as neuropathic pain, can lead to anxiety, depression, and other negative emotions, thereby forming comorbidities and increasing the risk of chronic pain over time. Both the infralimbic amygdala (IL) and the basolateral amygdala (BLA) are significantly associated with negative emotions and pain, and they are known to have reciprocal connections. However, the role of IL-BLA circuit pathways in neuropathic pain-induced anxiety and depression remains unexplored. Electroacupuncture (EA) is frequently employed in the treatment of chronic pain and emotional disorders. However, The mechanism by which EA mediates its analgesic and emotion-alleviating effects via the IL-BLA circuit remains uncertain. Here, we used chemogenetic manipulation combined with behavioral tests to detect pain induced anxiety-like and depression-like behaviors. We observed that activation of the IL-BLA circuit by chemogenetic activation induced depression-like behavior of mice. Additionally, we discovered that chemogenetic activation of the IL-BLA circuit successfully prevented the beneficial effects of EA on depression-like behavior brought on by chronic pain in mice with spared nerve injury (SNI). We discovered that SNI-induced depression-like behavior could be mitigated by inhibiting the circuit, and EA had a comparable depressive-relieving effect. Furthermore, the IL-BLA circuit's activation or inhibition had no effect on the anxiety-like feelings brought on by SNI. Overall, our findings identify a specific neural circuit that selectively regulates pain-induced depression-like emotions, without affecting pain-induced anxiety-like emotions. This discovery offers a precise target for future treatments of comorbid pain and depression and provides a plausible explanation for the efficacy of EA in treating depression-like emotions associated with chronic pain.

Breaking the Limitations of Activity and Stability in Powdered Materials for Oxygen Evolution Reaction: The Critical Role of Catalyst-Inducing Seeds

Powdered catalysts are extensively employed in industrial-scale energy conversion devices but struggle with weak powder-substrate adhesion and inherent instability in gas-evolving and highly oxidative oxygen evolution reactions (OER). This work introduces an innovative strategy in which powdered materials serve a critical role as catalyst-inducing seeds to break these limitations. Specifically, powdered Ti2CTx MXene with anchored cobalt single atoms (Co-SAs) shows negligible catalytic activity on its own but serves as catalyst-inducing seeds, significantly enhancing the catalytic activity of the conductive FeNi substrate. Mechanistic studies demonstrate that Co-SAs accelerate the oxidation rate of Ti2CTx, leading to the micro-battery corrosion behavior between oxidized Co/Ti2CTx and FeNi alloy, which generates highly OER-active corrosion products tightly bonded to FeNi alloy, thereby enhancing catalytic activity and ensuring stability. The prepared porous electrode shows a low overpotential of 303mV to deliver an ultra-high current density of 1000mAcm-2 and maintains activity for 1200hours under high current density conditions, rivaling advanced self-supporting electrodes. Moreover, replacing Co in Co/Ti2CTx with metals like Fe, Ni or Mn, yields comparable effects, suggesting the scalability of catalyst-inducing seeds. This approach breaks traditional limitations of powdered materials in OER, offering an effective pathway to engineer advanced catalytic electrodes.

Comparative effectiveness of different corticosteroid regimens in severe alcohol-associated hepatitis.

Comparative effectiveness of different corticosteroid regimens in severe alcohol-associated hepatitis.

Exploring Pt-Cu Synergistic Effects on Porous SiO2 Support With Different Pt Loadings for Low-temperature Oxidation of CO and C3H6

To address the high cost of noble metals, this study aims to optimize Pt loading and the synergistic effect of Cu on porous SiO2 support for low-temperature oxidation of CO and C3H6. A simulated test bench system was used to evaluate the performance of PtxCu1/SiO2 (where x= 0, 0.3, 0.5, 0.7, and 1wt%), Cu1/SiO2 and Ptx/SiO2 (where x= 0.5 and 1wt%) catalysts with varying Pt loadings. Comprehensive characterization, including BET, XRD, SEM, TEM, and XPS was conducted to assess particle size, structure, and surface morphology. The effects of Pt incorporation on reduction and oxidation properties were further examined using H2-TPR and CO-TPD techniques. Results demonstrated a significant enhancement in catalytic activity with the addition of Cu confirming a synergistic interaction between Pt and Cu. This synergy was particularly pronounced in lower Pt loadings, where PtxCu1/SiO2 composites outperformed Ptx/SiO2 in catalytic activity. Pt addition reduced the particle size, which resulted in the creation of PtCu alloy, with 1 and 0.7% wt Pt loading exhibiting comparable effects in CO conversion and 0.7% Pt loading exhibiting better activity at higher temperatures in C3H6 oxidation indicating that catalytic activity was maintained even with a reduced Pt loading. Additionally, minimal difference in activity for C3H6 oxidation was observed among PtxCu1/SiO2 catalysts with 0.7, 0.5, and 0.3wt% Pt loadings as indicated by T50 and T80 values. Reducing Pt loading from 0.7wt% had minimal impact on catalytic efficiency for C3H6 oxidation with catalysts maintaining high activity. 0.7wt% Pt loadings provide sufficient active sites for effective CO and HC oxidation. The enhanced catalytic activity and stability of bimetallic catalysts over monometallic Cu/SiO2 and Pt/SiO2 result from the simultaneous presence of active sites created by the synergetic effect of PtCu alloy formation with optimal ratio and well-optimized surface. These findings demonstrate the potential to optimize Pt usage without compromising catalytic performance, offering a cost-effective approach to catalyst design.

Comparative effectiveness of lifestyle interventions on children's body composition management: A systematic review and network meta-analysis

Comparative effectiveness of lifestyle interventions on children's body composition management: A systematic review and network meta-analysis

Digital motor intervention effects on motor performance of individuals with developmental disabilities: a systematic review.

Individuals (i.e. children/young adults) with developmental disabilities (DDs) and intellectual disabilities (IDs) often display a variety of physical and motor impairments. It is well known that participation in motor activities can positively impact the development of children's cognitive and social skills. Recently, virtual and digital technologies (e.g. video conferencing applications, virtual reality and video gaming) have been increasingly used to promote better physical/motor outcomes. The efficacy of digital technologies in improving motor outcomes for those with DD/ID varies depending on the technology and population, and the comparative effects of various technologies are unknown. The aim of our study is to conduct a systematic review to comprehensively examine the quantitative and qualitative results of current studies reporting the efficacy of digitally based motor interventions on motor outcomes in individuals with DD/ID. Literature published from 1900 to 2024 was searched in four health sciences databases: PubMed, PsycINFO, Scopus and CINAHL. Articles that examined the effects of gross motor/physical activity training using technologies such as exergaming (i.e. exercise through video gaming such as the Wii and Xbox Kinect), virtual reality or telehealth video conferencing applications (i.e. Zoom, Webex or mobile health apps) on the standardised or game-specific gross motor performance of individuals with DD/ID diagnoses that do not typically experience significant walking challenges using experimental or quasi-experimental study designs were included. Thirty relevant articles were retrieved from a search of the databases PubMed (914), PsycINFO (1201), Scopus (1910) and CINAHL (948). Our quantitative synthesis of this published literature suggests strong and consistent evidence of small-to-large improvements in motor skill performance following digital movement interventions. Our review supports the use of digital motor interventions to support motor skill performance in individuals with DD without ID. Digital technologies can provide a more engaging option for therapists to promote motor skill development in individuals with DD or for caregivers to use as an adjunct to skilled therapy.