Controlled Study Research Articles

Species selection as a key factor in the afforestation of coastal salt-affected lands: Insights from pot and field experiments

Soil salinization is a significant global issue that leads to land degradation and loss of ecological function. In coastal areas, salinization hampers vegetation growth, and forestation efforts can accelerate the recovery of ecological functions and enhance resilience to extreme climates. However, the salinity tolerance of tree species varies due to complex biological factors, and results between lab/greenhouse and field studies are often inconsistent. Moreover, in salinized areas affected by extreme climatic and human impacts, afforestation with indigenous species may face adaptability challenges. Therefore, it is crucial to select appropriate cross-species salinity tolerance indicators that have been validated in the field to enhance the success of afforestation and reforestation efforts. This study focuses on five native coastal tree species in Taiwan, conducting afforestation experiments on salt-affected soils mixed with construction and demolition waste. It integrates short-term controlled experiments with potted seedlings and long-term field observations to establish growth performance and physiological and biochemical parameters indicative of salinity tolerance. Results showed that Heritiera littoralis Dryand. exhibited the highest salinity tolerance, accumulating significant leaf proline under increased salinity. Conversely, Melia azedarach Linn. had the lowest tolerance, evidenced by complete defoliation and reduced biomass under salt stress. Generally, the field growth performance of these species aligns with the results of short-term pot experiments. Leaf malondialdehyde content from pot experiments proved to be a reliable cross-species salinity tolerance indicator, correlating negatively with field relative height growth and survival rates. Additionally, parameters related to the photosynthetic system or water status, measured using portable devices, also moderately indicated field survival, aiding in identifying potential salt-tolerant tree species. This study underscores the pivotal role of species selection in afforestation success, demonstrating that small-scale, short-term salinity control experiments coupled with appropriate assessment tools can effectively identify species suitable for highly saline and degraded environments. This approach not only increases the success of afforestation but also conserves resources needed for field replanting and maintenance, supporting sustainable development goals.

Polymerase Chain Reaction Cleaner with Antibacterial Effect and Faster Elimination of Nucleic Acid Aerosol Pollution

With advancement of nucleic acid detection technology, most universities, biological testing companies, and hospitals have Polymerase Chain Reaction (PCR) laboratories. PCR detection technology is the core technology for nucleic acid detection. When nucleic acid detection is performed in a PCR laboratory, nucleic acid aerosol samples are often dispersed to the environment in the form of aerosols. At this time, there will be some nucleic acid contamination in the PCR laboratory, resulting in false positive samples. The purpose of this paper is to propose a new type of nucleic acid pollution scavenger called PCR Cleaner. Firstly, the best ratio of PCR Cleaner was obtained by a control experiment, and then the antibacterial test for the PCR Cleaner was carried by comparing the nucleic acid pollution removal efficiency of different ratios of PCR Cleaner and common nucleic acid pollution scavenger on the surface and in the air. Experiment results showed that, the removal efficiency of PCR Cleaner on the surface of nucleic acid was much higher than that of alcohol and aqueous solution. Its effect was good enough when compared to the two commonly used nucleic acid pollution scavengers (DNA/RNA-ExitusPlus and PCR clean). The antibacterial and bacteriostatic PCR Cleaner can significantly inhibit the growth of high concentration of E. coli, and can also completely inhibit the low concentration of E. coli.

Gestational diabetes mellitus and development of intergenerational non-alcoholic fatty liver disease (NAFLD) after delivery: a systematic review and meta-analysis

It is known that gestational diabetes mellitus (GDM)-complicated pregnancies could affect maternal cardiometabolic health after delivery, resulting in hepatic dysfunction and a heightened risk of developing non-alcoholic fatty liver disease (NAFLD). Hence, this study aims to summarise existing literature on the impact of GDM on NAFLD in mothers and investigate the intergenerational impact on NAFLD in offspring. Using 4 databases (PubMed, Embase, Web of Science and Scopus) between January 1980 and December 2023, randomized controlled trials and observational studies that assessed the effect of maternal GDM on intergenerational liver outcomes were extracted and analysed using random-effects meta-analysis to investigate the effect of GDM on NAFLD in mothers and offspring. Pooled odds ratio (OR) was calculated using hazards ratio (HR), relative risk (RR), or OR reported from each study, with corresponding 95% confidence intervals (CI), and statistical heterogeneity was assessed with the Cochran Q-test and I2 statistic, with two-sided p values. The study protocol was pre-registered on PROSPERO (CRD42023392428). Twenty studies pertaining to mothers and offspring met the inclusion criteria and 12 papers were included further for meta-analysis on intergenerational NAFLD development. Compared with mothers without a history of GDM, mothers with a history of GDM had a 50% increased risk of developing NAFLD (OR 1.50; 95% CI: 1.21-1.87, over a follow-up period of 16 months-25 years. Similarly, compared with offspring born to non-GDM-complicated pregnancies, offspring born to GDM-complicated pregnancies displayed an approximately two-fold elevated risk of NAFLD development (2.14; 1.57-2.92), over a follow-up period of 1-17.8 years. This systematic review and meta-analysis suggests that both mothers and offspring from GDM-complicated pregnancies exhibit a greater risk to develop NAFLD. These findings underline the importance of early monitoring of liver function and prompt intervention of NAFLD in both generations from GDM-complicated pregnancies. No funding was available for this research.

Microdosing Plyometric Training Enhances Jumping Performance, Reactive Strength Index, and Acceleration among Youth Soccer Players: A Randomized Controlled Study Design

Microdosing can facilitate better accommodation to the training stimulus while aligning with the scheduling needs of teams. In this study, the effectiveness of microdosing exposure was investigated by comparing the effects of microdosing plyometric jump training (microPJT) with those of regular plyometric jump training (regPJT) and a control group not exposed to plyometric training. The comparison focused on the effects on jumping performance, reactive strength index (RSI), and acceleration over a 10-meter distance. Fifty-two male youth soccer players (16.3 ± 0.6 years old) from under-17 teams participated in a randomized controlled study, with interventions lasting 8 weeks. Assessments were conducted twice, before and after the intervention, measuring squat jump (SJ), countermovement jump (CMJ), RSI during drop jumps, and acceleration in a 10-meter sprint test. The regPJT group completed 34 bilateral jumps and 48 unilateral jumps per week over two weekly sessions, totaling 82 jumps. Conversely, the microPJT group performed 17 bilateral jumps and 24 unilateral jumps weekly over 4 sessions week, totaling 41 jumps. Significant interactions between groups and time were observed concerning SJ (p < 0.001; η2= 0.282), CMJ (p < 0.001; η2= 0.368), RSI (p < 0.001; η2= 0.400) and 10-m sprint time (p < 0.001; η2 = 0.317). Between-group analysis indicated that both the microPJT (p < 0.001) and regPJT (p < 0.001) groups exhibited significant better results compared to the control group in post-intervention evaluation of SJ, CMJ, RSI and 10-m sprint time, while no significant differences were found between experimental groups (p > 0.050). In conclusion, this study has revealed that both microPJT and regPJT are equally effective in enhancing jumping performance and acceleration time in soccer players. This suggests that a smaller training volume, distributed more frequently across the week, can effectively induce improvements in soccer players.

The Role of Trublue Laser in Cholesteatoma Surgery.

The retrospective cohort study aimed to determine the safety and efficacy of TruBlue laser application in cholesteatoma surgeries. All cholesteatoma surgeries conducted from January 2018 to January 2022 in two tertiary referral hospitals in Hong Kong, with and without use of TruBlue laser, were included. Pure tone audiogram was done pre- and post-operatively to assess hearing. Disease extent was graded with ChOLE score and ChOLE staging. Residual disease was determined clinically, radiologically, or surgically with second look operation. One hundred twenty cholesteatoma cases were identified. There are 39.2% (n = 47) of the cholesteatoma surgeries that utilized TruBlue laser, while 60.8% (n = 73) did not. Overall follow-up duration was 21 ± 12.4 months, ranging from 2 to 47 months. Both groups were similar in demographics, pre-operative hearing and ChOLE staging. The length of stay was comparable in both groups (2 ± 2 days in nonlaser, 1 ± 1 day in laser, p = 0.31). There was no facial nerve injury related to surgery in both groups, and overall complication rates were similar (4.1% in nonlaser, 4.3% in laser, p = 0.97). The postoperative hearing was comparable with good hearing preservation in both groups. Residual cholesteatoma occurred in 17.8% (n = 13) in nonlaser group, and 21.3% (n = 10) in laser group, which was not statistically significant (p = 0.64). Seventy percent of the cholesteatoma residual in laser group occurred at area that TruBlue LASER cannot be applied. TruBlue LASER was safe in cholesteatoma surgeries, though no added benefits were shown in reducing cholesteatoma residual rate. A larger controlled study is warranted to discern the true effect of TruBlue LASER. Level 3.

Individualized Traditional Chinese Medicine treatment antibiotics for recurrent urinary tract infections: a multicenter, randomized controlled study.

To systematically assess the effects of individualized Chinese medicines on recurrent urinary tract infections (rUTIs). This study recruited 230 adult female patients in the remission phase of rUTIs from five hospitals in China. The patients were randomly allocated to two groups: an individualized Chinese medicine group (n = 114) and a control group (n = 116). Patients in the Chinese medicine group received individualized Chinese herbs, which were evaluated for syndrome differentiation. Patients in the control group received antibiotic treatment combined with a Chinese medicine placebo. The duration of treatment was three courses of four weeks each, with a three-month subsequent follow-up. UTI recurrence rate, Traditional Chinese Medicine (TCM) syndrome scores, 36-item Short Form Survey (SF-36) score, and urine secretory immunoglobulin A (SIgA) were measured and analyzed before and after treatment in each group. Patients from the Chinese medicine group exhibited significant decreases in both short- and long-term UTI recurrence rates compared with the control group (P < 0.05). The changes in TCM syndrome scores between the Chinese medicine and control groups were significant (P < 0.05). The changes in the average SF-36 quality-of-life scores in the Chinese medicine group were also significantly higher than those in the control group after treatment (P < 0.05). The Chinese medicine group also demonstrated a significant increase in urine SIgA expression. Taken together, compared to the often-used long-term antimicrobial prophylaxis during the remission stage of rUTIs, treating patients with an individualized Chinese medicine decoction by syndrome differentiation could effectively reduce the recurrence rate, improve the patients' TCM syndrome scores and quality of life, and enhance immunity, which in turn helps to prevent antibiotic resistance.

Jumping Interval Training: An Effective Training Method for Enhancing Anaerobic, Aerobic, and Jumping Performances in Aerobic Gymnastics

The aim of this study was to compare the effects of jumping interval training (JIT) and running high-intensity interval training (HIIT) on the aerobic, anaerobic and jumping performances of youth female aerobic gymnasts. A randomized controlled study was conducted over an 8-week period, involving 73 youth female athletes (16.2 ± 1.3 years old) of aerobic gymnastics. The study comprised two experimental groups (JIT and HIIT) and a control group. Participants in the experimental groups engaged in two additional training sessions per week alongside their regular training regimen, while the control group followed their usual training routine. Before and after the intervention period, gymnasts were assessed for their performance in the countermovement jump test (CMJ), the specific aerobic gymnastics anaerobic test (SAGAT) and the 20-m multistage fitness test. Significant interactions time × group were found in SAGAT (p &lt; 0.001; = 0.495), CMJ (p &lt; 0.001; = 0.338) and 20-m multistage fitness test (p &lt; 0.001; = 0.500). The time × group analysis post-intervention revealed significantly lower scores in SAGAT for the control group compared to the JIT (p = 0.003) and HIIT (p = 0.034). Additionally, significantly higher scores were observed for the JIT group in the CMJ test compared to the HIIT (p = 0.020) and control (p = 0.028) groups following the intervention. Finally, the 20 m multistage fitness test post-intervention revealed significantly lower scores for the control group compared to JIT (p &lt; 0.001) and HIIT (p &lt; 0.001). Both JIT and HIIT are recommended training strategies to adopt in aerobic gymnastics for significantly improving the aerobic and anaerobic performances of athletes. However, JIT may be particularly relevant to use as it offers additional benefits in improving vertical jumping performances.

Efficacy of substances containing 3 types of active ingredients-saponins, flavones, and alkaloids in regulation of cytokines in autoimmune diseases a systematic review and Meta-analysis based on animal studies.

To investigate the efficacy of substances containing 3 types of active ingredients-saponins, flavones, and alkaloids on experimental animals with autoimmune diseases (AIDs). The protocol for this systematic review and Meta-analysis was prospectively registered with PROSPERO (CRD42023395741). Searches were conducted in the China National Knowledge Infrastructure, Wanfang, Chinese Science and Technology Journals, China Biomedical, PubMed, Cochrane Library, and Embase databases to screen for animal studies investigating the therapeutic effects of saponins, flavones, or alkaloids on autoimmune diseases; consequently, corresponding data extraction tables were prepared. Systematic Review Centre for Laboratory Animal Experimentation was used to assess the risk of methodological bias in the included literature. RevMan 5.4 was used for the Meta-analysis on the 8 serum cytokines. A total of 31 studies were included, all of which were randomized controlled studies. Meta-analysis indicated that substances rich in saponins, flavones, and alkaloids reduced serum levels of interleukin (IL)-1β [standardized mean difference (SMD) = -1.94, 95% confidence interval (CI) (-2.99, -0.90), P = 0.0003], IL-6 [SMD = -1.65, 95% CI (-2.33, -0.97,) P < 0.000 01], IL-17 [SMD = -2.41, 95% CI (-3.61, -1.20), P < 0.0001], tumor necrosis factor (TNF)-α [SMD = -1.84, 95% CI (-2.61, -1.06), P < 0.0001], and interferon (IFN)-γ [SMD = -1.54, 95% CI (-2.43, -0.65), P = 0.0007], but increased serum levels of IL-4 [SMD = 1.30, 95% CI (0.15, 2.44), P = 0.03) and IL-10 [SMD = 2.05, 95% CI (1.39, 2.70), P < 0.000 01) in animal models. However, no significant regulatory effect of these three active components was observed on serum levels of IL-2 [SMD = -0.63, 95% CI (-1.82, 0.57), P = 0.30]. Substances containing saponins, flavones, and alkaloids regulated the changes of immune-related cytokines, it may be a novel dietary substance to relieve and control autoimmune diseases in the future.

Impact of Preoperative Aripiprazole on Postoperative Analgesia in Laparoscopic Hysterectomy: A Randomized Double-blind Placebo-controlled Trial.

Aripiprazole is a second-generation atypical antipsychotic with worldwide clinical approval. Nevertheless, its perioperative antinociceptive application has not been studied. As a result, the purpose of this study was to investigate the analgesic effects of perioperative aripiprazole on reducing postoperative pain, as well as the possible adverse effects. This randomized controlled study enrolled 80 female patients scheduled for laparoscopic hysterectomy who were assigned randomly into 2 equal groups in 1:1; aripiprazole group (n = 40), patients received an aripiprazole 30mg tablet orally 3 hours before surgery and placebo group (n = 40), patients received a placebo tablet 3 hours before surgery. The 24-hour morphine consumption postoperatively was the primary outcome, and the time to the first analgesic request, sedation scores, and the incidence of perioperative adverse events were the secondary outcomes. The mean 24-hour morphine consumption was significantly lower with aripiprazole (2.5 ± 0.5mg) than with placebo (23.7 ± 1.6mg; mean ± SE -21.2 ± 0.3, 95% CI: -21.7 to -20.6, P < 0.001). In addition, the mean time to the first analgesic request was significantly longer with aripiprazole (212.2 ± 14.7min) than with placebo (27.0 ± 2.0min; mean ± SE 185.2 ± 2.3, 95% CI: 180.5 to 189.8, P < 0.001). Furthermore, the aripiprazole group reported higher sedation scores ( P < 0.001). Bradycardia and hypotension were reported more frequently among patients in the aripiprazole group ( P < 0.05). Aripiprazole was effective in reducing pain after laparoscopic hysterectomy. Although self-limited, side effects should be taken into consideration when using the medication perioperatively.

디지털 헬스 프로그램이 국내 노인의 인지기능과 우울에 미치는 효과

Objectives This study is a systematic review and meta-analysis on the effects of a digital health intervention pro-gram applied to the elderly in Korea on cognitive function and depression. Methods For the meta-analysis, a total of 4,261 articles were searched using five domestic academic search da-tabases, RISS, NDSL, KISS, Kmbase, and DBpia, until January 11, 2024. The literature search targeted only aca-demic journal papers, and there was no limit to the search period. A total of 11 studies were included in the meta-analysis according to the data selection and exclusion criteria, and effect size and heterogeneity were ana-lyzed using the R 4.3.2 program. Results Among the 11 selected papers, 5 were randomized controlled experimental studies and 6 were non-randomized controlled studies, and the effect size of the digital health intervention program for the elderly in Korea on cognitive function was 0.30 (95% CI: -0.01~-0.60) ), which was a small effect size, and the effect size for depression of the digital health intervention program for the elderly in Korea was a large effect size of -0.80 (95% CI: -1.13~-0.47). Conclusions Based on the results of this study, the digital health intervention program was effective in improving cognitive function and reducing depression in the elderly. Based on this, the development of an intervention pro-gram effective in improving cognitive function and reducing depression and the basis for educational strategies using digital in university education It can be used as data.

Thyroid function changes during growth hormone therapy in pediatric patients: a controlled study and review of recent data

Introduction: Growth hormone therapy is a cornerstone treatment for children with GHD and ISS. Its impact on the hypothalamic-pituitary-thyroid axis, however, has been a subject of ongoing research. This review compiles findings from several studies spanning three decades and contrasts them with recent data to enhance our understanding of thyroid function dynamics during GH therapy. Review of Literature: Early Observations (1992-2005) Pirazzoli et al. (1992) and Tang et al. (1997) were among the first to document changes in thyroid function due to GH therapy, noting enhanced peripheral conversion of T4 to T3 and a prevalence of subclinical hypothyroidism. Wyatt et al. (1998) reported significant decreases in T4 and increases in T3, indicating a notable shift in thyroid hormone levels early in GH therapy. Mid-Term Studies (2005-2015) Seminara et al. (2005) and Kalina-Faska et al. (2004) reported changes in thyroid function, particularly a decrease in T4 levels and a transient increase in fT3 during the early stages of GH therapy. · Recent Developments (2016-Present) Wang Ying and Liang Furong (2016) emphasized the need for vigilant monitoring of thyroid hormone levels, aligning with Zheng et al. (2014) who noted improvements in lipid metabolism without significant thyroid function impacts. Glynn et al. (2017, 2018) and Kucharska et al. (2021) focused on the complexities of the biological effects of GH-induced changes in thyroid hormones. Comparison with our Data Our recent study reveals subtle changes in thyroid function in GH-treated children with GHD and ISS. We observed a slight decrease in mean FT4 and an increase in mean TSH in the GH treatment group, stable TSH and decreased FT4 in the ISS treatment group, and significant decreases in both FT4 and TSH in the no-treatment group. These findings corroborate the trend seen in earlier studies, highlighting the multifaceted nature of thyroid function changes during GH therapy. Conclusions: The review underscores that GH therapy can significantly influence thyroid function, necessitating regular monitoring of thyroid hormone levels. The variation in thyroid responses suggests a complex interaction between GH therapy and the hypothalamic-pituitary-thyroid axis, which may be influenced by factors like age, severity of GHD, and duration of GH treatment.

The Effectiveness of Hammock Positioning in Regulating Behavioral Patterns in Preterm: A Systematic Review

Background- Preterm newborns benefit from supportive developmental techniques such as hammock placement, which give them a sense of being in the womb that promotes calm, relaxation, and deep restful sleep. Objective- To identify and synthesize the available evidence on the effect of hammock positioning in regulating behavioral patterns and sleep in preterm infants admitted to the NICU Data Sources: We searched the Google Scholar, Pubmed, and Scopus databases for reports of primary research studies using a three-step strategy. We also searched for and reviewed the reference lists of retrieved articles. Methods: We included data from randomized controlled trials, Quasi-experimental and Comparative study measuring the effects of hammock positioning on physiological stress outcomes, defined as oxygen saturation, body temperature, heart rate and respiratory rate, Sleep-wakefulness, and behavioral pattern. The PRISMA model was used to conduct data extraction. We performed a narrative synthesis of all studies when data were available from multiple studies. Results: Five studies were eligible for inclusion. Infants who received hammock positioning has shown to have a higher mean heart rate, oxygen saturation and temperature, Sleep-wakefulness and improved behavioral patterns. Conclusions: Current evidence suggests that hammock positioning in the neonatal intensive care unit setting is a safe method that may significantly affect some of the physiological parameters of stress, improved behavioral patterns and Sleep-wakefulness in preterm infants. However, due to clinical heterogeneity, further studies are needed to assess the effects of physiological stress in the neonatal intensive care unit on the development of preterm infants.

Posterior reversible encephalopathy syndrome with functional and motor sequelae: A case report

Posterior Reversible Encephalopathy Syndrome (PRES) is a rare clinicoradiological neurological disorder, initially elucidated in 1996, Since this first description of PRES numerous case reports and case series, as well as retrospective observational studies describing the syndrome have been published. Importantly, no randomized controlled studies have been performed, We present the case of a young patient with no significant medical history who presented with neurological symptoms consistent with Posterior Reversible Encephalopathy Syndrome (PRES). Brain MRI confirmed the diagnosis of Posterior Reversible Encephalopathy Syndrome (PRES). Additionally, the etiological assessment yielded negative results. A notable aspect in our patient's case is the persistence of sequelae, characterized by dexterity and grip impairment on the right side, hindering various activities of daily living. The diagnosis of PRES is both radiological and clinical, with MRI playing a crucial role. Treatment is primarily symptomatic, sometimes requiring intensive care unit admission. Prognosis is favorable in the majority of cases, but severe complications and even death can occur. The reversibility of initial symptoms is well-documented in the literature. Long-term functional impairment outcomes following PRES have not been adequately characterized in the literature. Therefore, it is necessary to conduct follow-up screenings in more patients presenting both typical and atypical PRES syndromes. This will provide insight into whether the functional and motor sequelae of PRES are less reversible.

Menetrier‘s disease, an uncommon disease and a diagnostic challenge: Case Report

Acquired hypoproteinemic, hypertrophic gastropathy also known as Menetrier’s disease is one of the infrequently encountered disorders in clinical practice. Understanding of the pathogenesis, diagnostic features and course of this disease is important as the symptoms may closely resemble a variety of other conditions like malignancies. one of the case control studies, the disease is found to be associated with increased mortality and can predispose to adenocarcinoma

Antibiotic-Impregnated Ventriculoperitoneal Shunts Decrease Bacterial Shunt Infection: A Systematic Review and Meta-Analysis.

Antibiotic-impregnated shunts seem to be beneficial in preventing bacterial infections and decreasing mortality by effectively inhibiting microbial growth in the shunt system and reducing the risk of shunt-associated infections. This study aimed to evaluate the efficacy of antibiotic-impregnated shunt catheters (AISC) in reducing the incidence of bacterial shunt infection in patients with hydrocephalus. The protocol was registered on PROSPERO. A meta-analysis was conducted by searching 3 databases (PubMed, Scopus, CENTRAL) for relevant randomized controlled trials and observational studies. We included all studies published until November 2022 in any language. The primary outcome was the rate of bacterial infections, whereas the rate of shunt failure was our secondary endpoint. Odds ratios (OR) with 95% CI were calculated using a random-effects model. A total of 27 articles with 27 266 shunt operations were included in this study. The results indicated that using AISC is significantly associated with reduction in infections (OR = 0.42; 95% CI: 0.33-0.54). Regarding shunt failure, there was a tendency in favor of AISC use (OR = 0.73; 95% CI: 0.51-1.06). Our study provided evidence that AISC is significantly associated with the reduction in the rate of bacterial ventriculoperitoneal-shunt infection. In addition, there was a tendency toward AISC to decrease shunt failure compared with the standard shunt.

Hybrid Palladium-Catalyzed Intramolecular Carboamination of Conjugated Dienes: Synthesis of Functionalized Pyrrolidines via Selective Trifluoromethylarene Defluorination.

The incorporation of difluoromethylene groups into aza-heterocycles represents a compelling yet underexplored avenue in contemporary chemical research. In this study, we unveil a hybrid palladium-catalyzed intramolecular gem-difluoroalkylamination of conjugated dienes, providing a versatile approach to the synthesis of diverse functionalized pyrrolidines. Noteworthy features include mild reaction conditions and a remarkable tolerance toward various functional groups. Additionally, the use of alkyl iodides as electrophiles facilitates the generation of the corresponding alkylamination products. Control experiments support a proposed hybrid palladium-catalyzed radical-polar crossover pathway, offering insights into the underlying chemical processes governing this transformation.

A Type of Chiral C2-Symmetric Arylthiol Catalyst for Highly Enantioselective Anti-Markovnikov Hydroamination.

The development of chiral hydrogen donor catalysts is fundamental in the expansion and innovation of asymmetric organocatalyzed reactions via an enantioselective hydrogen atom transfer (HAT) process. Herein, an unprecedented type of chiral C2-symmetric arylthiol catalysts derived from readily available enantiomeric lactate ester was developed. With these catalysts, an asymmetric anti-Markovnikov alkene hydroamination-cyclization reaction was established, affording a variety of pharmaceutically interesting 3-substituted piperidines with moderate to high enantioselectivity. Results of the designed control experiments and theoretical computation rationalized the origin of stereocontrol and disclosed the spatial effect of the moiety of chiral thiols on the enantioselectivity. We believed the facile synthesis, flexible tunability, and effective enantioselectivity-controlling capability of these catalysts would shed light on the development of versatile chiral HAT catalysts and related asymmetric reactions.

Occupational particle exposure and chronic kidney disease: a cohort study in Swedish construction workers

ObjectivesIncreasing epidemiological and experimental evidence suggests that particle exposure is an environmental risk factor for chronic kidney disease (CKD). However, only a few case–control studies have investigated this association in...

Joint Modeling of Gene-Environment Correlations and Interactions Using Polygenic Risk Scores in Case-Control Studies.

Polygenic risk scores (PRS) are rapidly emerging as a way to measure disease risk by aggregating multiple genetic variants. Understanding the interplay of PRS with environmental factors is critical for interpreting and applying PRS in a wide variety of settings. We develop an efficient method for simultaneously modeling gene-environment correlations and interactions using PRS in case control studies. We use a logistic-normal regression modeling framework to specify the disease risk and PRS distribution in the underlying population and propose joint inference across the two models using the retrospective likelihood of the case-control data. Extensive simulation studies demonstrate the flexibility of the method in trading-off bias and efficiency for the estimation of various model parameters compared to the standard logistic regression or a case-only analysis for gene-environment interactions, or a control-only analysis for gene-environment correlations. Finally using simulated case-control data sets within the UK Biobank study, we demonstrate the power of our method for its ability to recover results from the full prospective cohort for the detection of an interaction between long-term oral contraceptive use and PRS on the risk of breast cancer. This method is computationally efficient and implemented in a user-friendly R package.

Information technology-supported integrated health service for older adults in long-term care settings

BackgroundTo examine the effectiveness and safety of a data sharing and comprehensive management platform for institutionalized older patients.MethodsWe applied information technology-supported integrated health service platform to patients who live at long-term care hospitals (LTCHs) and nursing homes (NHs) with cluster randomized controlled study. We enrolled 555 patients aged 65 or older (461 from 7 LTCHs, 94 from 5 NHs). For the intervention group, a tablet-based platform comprising comprehensive geriatric assessment, disease management, potentially inappropriate medication (PIM) management, rehabilitation program, and screening for adverse events and warning alarms were provided for physicians or nurses. The control group was managed with usual care. Co-primary outcomes were (1) control rate of hypertension and diabetes, (2) medication adjustment (PIM prescription rate, proportion of polypharmacy), and (3) combination of potential quality-of-care problems (composite quality indicator) from the interRAI assessment system which assessed after 3-month of intervention.ResultsWe screened 1119 patients and included 555 patients (control; 289, intervention; 266) for analysis. Patients allocated to the intervention group had better cognitive function and took less medications and PIMs at baseline. The diabetes control rate (OR = 2.61, 95% CI 1.37–4.99, p = 0.0035), discontinuation of PIM (OR = 4.65, 95% CI 2.41–8.97, p < 0.0001), reduction of medication in patients with polypharmacy (OR = 1.98, 95% CI 1.24–3.16, p = 0.0042), and number of PIMs use (ꞵ = − 0.27, p < 0.0001) improved significantly in the intervention group. There was no significant difference in hypertension control rate (OR = 0.54, 95% CI 0.20–1.43, p = 0.2129), proportion of polypharmacy (OR = 1.40, 95% CI 0.75–2.60, p = 0.2863), and improvement of composite quality indicators (ꞵ = 0.03, p = 0.2094). For secondary outcomes, cognitive and motor function, quality of life, and unplanned hospitalization were not different significantly between groups.ConclusionsThe information technology-supported integrated health service effectively reduced PIM use and controlled diabetes among older patients in LTCH or NH without functional decline or increase of healthcare utilization.Trial registrationClinical Research Information Service, KCT0004360. Registered on 21 October 2019.