Controlled Study Research Articles

Incorporation of a Binuclear Cobalt Complex into MOFs for Photocatalytic CO2 Reduction with H2O as an Electron Donor.

The development of molecular composite photocatalysts for cost-effective, sacrificial-reagent-free CO2 reduction is desirable but challenging. Herein, we employed an in situ encapsulation strategy to encapsulate the binuclear cobalt complex (Co2L) within NH2-MIL-125 and synthesized a range of MOF-based composites with varying cobalt content for photocatalytic CO2 reduction. The photocatalytic results showed that the catalytic performance increased with the increase in Co2L content, reaching a rapid CO generation rate of 27.95 μmol·g-1·h-1, over 5 times that of bare NH2-MIL-125, with water as the electron donor instead of any organic sacrificial agent. This composite catalyst effectively harnesses the advantages of both molecular catalysts and MOFs, leveraging the superior catalytic activity of molecular catalysts while also capitalizing on the light absorption and water oxidation capabilities of MOFs, resulting in a remarkable ability for photocatalytic CO2 reduction. The photocatalytic mechanism involving electron transfer and CO2 activation has been revealed by photoluminescence spectroscopy, in situ X-ray photoelectron spectroscopy, in situ diffuse reflectance infrared Fourier transform spectroscopy, and other control experiments.

C-Reactive Protein Biosensor for Diagnosing Infections Caused by Orthopedic Trauma.

Infections linked to orthopedic trauma are common complications that place a significant strain on the healthcare system. Immediate identification of the infection and its severity is essential for providing effective treatment. C-reactive Protein (CRP) is a commonly used inflammatory marker in orthopedic surgery and has proven to be a valuable biomarker for diagnosing and monitoring infections. Specifically, CRP aids in the early identification of postoperative infections. This research work has focused on developing a highly sensitive CRP biosensor using iron oxide nanomaterial-modified dielectric sensors. Gold Urchin (GU)-conjugated aptamers and antibodies were used as probes and attached to the electrode via amine linkers. The aptamer-GU-antibody-modified electrode detected CRP at concentrations as low as 1 pg/mL, with an R2 value of 0.9942. Furthermore, CRP-spiked serum exhibited an increase in current response at all concentrations of CRP, indicating selective detection of CRP. Additionally, control experiments using complementary sequences of the aptamer, relevant proteins, and non-immune antibodies did not enhance the current responses, confirming the specific identification of CRP. The sensing strategy has enabled the detection of CRP at its lowest levels, facilitating the identification of infections during orthopedic surgery and subsequent treatment.

Synthesis of 5-Seleno-Substituted Spirocyclopenta[b]pyridine-2,5-dien-4-ones and Benzo[h]quinolines via Radical Cyclization of Arylethynylpyridines.

A practical strategy for obtaining novel 5-seleno-substituted spirocyclopenta[b]pyridines-2,5-dien-4-ones and benzo[h]quinolines via radical cyclization is reported. The synthetic protocol explores the reaction between arylethynylpyridines and diorganyl diselenides in acetonitrile as solvent and Oxone® as oxidant at 82 °C. This easy-to-handle, eco-friendly metal-free approach was carried out under an open atmosphere, affording functionalized organoselenium compounds in good to excellent yields. Control experiments and scale-up test were performed to demonstrate the efficiency of this methodology.

Head circumference and intelligence, schooling, employment, and income: a systematic review

BackgroundNo consensus exists about the role of head circumference in identifying children at risk of suboptimal development. The objective of this study was to evaluate the association between head circumference and intelligence, schooling, employment, and income. The review 1) summarizes the overall evidence and 2) restricts the evidence to a subset of articles that met minimum quality criteria.MethodsPubMed, Web of Science, PsycINFO, LILACS, CINAHL, WHO Institutional Repository for Information Sharing and UNICEF Innocenti were searched to identify published studies. Cohort, case–control or cross-sectional studies which evaluated the associations of interest in the general population, premature babies, babies with low birth weight or small for gestational age were included; head circumference must have been measured before the age of 20 years. Two reviewers independently performed study selection, data extraction and quality assessments.ResultsOf 2521 records identified, 115 were included and 21 met the minimum quality criteria. Ninety studies investigated if early measures of head circumference predict later outcomes and 25 studies measured head circumference and the outcome at the same timepoint; 78 studies adjusted the head circumference for age and sex. We identified large heterogeneity and inconsistency in the effect measures and data reported across studies. Despite the relatively large number of included articles, more than 80% presented serious limitations such as lack of adjustment for confounding and severe selection bias. Considering the subset of articles which met the minimum quality criteria, 12 of 16 articles showed positive association between head circumference and intelligence in the general population. However, in premature babies, 2 of 3 articles showed no clear effect. Head circumference was positively associated with academic performance in all investigated samples (5 of 5 articles). No article which evaluated educational attainment and employment met the minimum quality criteria, but the association between head circumference and these outcomes seems to be positive.ConclusionsLarger head circumferences are positively associated with higher levels of intelligence and academic performance in the general population, but there is evidence of non-linearity in those associations. Identifying a group of children in higher risk for worse outcomes by a simple and inexpensive tool could provide an opportunity to mitigate these negative effects. Further research is needed for a deeper understanding of the whole distribution of head circumference and its effect in premature babies. Authors should consider the non-linearity of the association in the data analysis.Trial registrationAssociation between head circumference and intelligence, educational attainment, employment, and income: A systematic review, CRD42021289998.

Effectiveness of Peer-Led Education in Reducing HIV Transmission among Youths in Urban Areas: A Comprehensive Review

HIV transmission among urban youths remains a significant public health concern, driven by factors such as risky sexual behaviors, limited access to healthcare, and high social connectivity. Peer-led education has emerged as a promising intervention to reduce HIV transmission by utilizing the influence of social networks and delivering relatable, accessible information on HIV prevention. This review assessed the effectiveness of peer-led education programs in urban areas by examining their impact on HIV-related knowledge, behavior change, and HIV testing rates. Studies revealed that peer-led education significantly improves HIV knowledge, promotes condom use, and encourages HIV testing among urban youths, contributing to a reduction in high-risk behaviors. Additionally, the social and emotional benefits of peer-led education create supportive environments for discussing sexual health, reducing stigma, and fostering empowerment among participants. However, challenges such as variability in program quality, sociocultural barriers, and sustainability issues limit the long-term success of these interventions. To address these challenges, future strategies should focus on integrating digital health platforms, personalizing peer education, and employing rigorous program evaluation methods. The methodology for this review included a comprehensive analysis of existing literature, including randomized controlled trials, systematic reviews, and observational studies, to provide a holistic understanding of peer-led education’s effectiveness in reducing HIV transmission among urban youths. Keywords: Peer-led education, HIV prevention, Urban youths, Behavioral change, HIV transmission.

Chalcogen Bond-Driven Alkylations: Selenoxide-Pillar[5]arene As A Recyclable Catalyst For Displacement Reactions In Water.

A novel strategy to catalyze alkylation reactions through chalcogen bond interaction using a supramolecular structure is presented herein. Utilizing just 1.0 mol% of selenoxide-pillar[5]arene (P[5]SeO) as the catalyst we achieved efficient catalysis in the cyanation of benzyl bromide in water. Our approach demonstrated high efficiency and effectiveness, with the results supported by designed control experiments and theoretical models, highlighting the catalytic effect of the pillar[5]arene through noncovalent interactions. Quantum-chemical calculations (ωB97X-D/def2-TZVP@SMD) pointed out that the catalyzed cyanation reaction followed an SN2-like mechanism, with energy barriers (ΔH‡) ranging from 16.7 to 18.2 kcal mol-1, exhibiting dissociative character depending on the para-substituent. 1H NMR analysis revealed that P[5]SeO acted as a catalyst through inclusion complex formation, facilitating the transfer of the electrophilic substrate to the aqueous solution for nucleophilic displacement. Our reaction protocol proved applicable to various substrates, including aromatic and alpha-carbonyl derivatives. The use of sodium azide as the nucleophile was also feasible. Importantly, our method allowed scalability, and the catalyst P[5]SeO could be recovered and reused effectively for multiple reaction cycles, showcasing sustainability.

Real-Life Data of Secukinumab in Patients with Moderate to Severe Plaque Psoriasis, Psoriatic Arthritis, and Ankylosing Spondylitis: Patient Baseline Characteristics Data from the PROMPT Study.

Secukinumab has proven to be effective and safe in psoriasis (PsO), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) in the phase3 studies. However, data on real-world practice is limited. This study is an ongoing, multicenter, 2-year observational study that focuses on patients with moderate to severe plaque PsO, active PsA, or AS receiving secukinumab. The aim of this study is to present baseline data for the entire study population. A total of 127 patients were enrolled, with 101having PsO, 12 with PsA, and 14 with AS. Among the patients, approximately 54.0% were male. The mean body mass index ranged from 25.0 to 27.4kg/m2 across all groups. Patients with PsO had the longest disease duration with an average of 11.0years, followed by AS (3.0years) and PsA (1.0year). Previous biologic therapy was observed in 6.9-8.1% of patients. Baseline disease severity scores revealed moderate to severe disease. In the PsO group, the mean Psoriasis Area and Severity Index score was 16.1. For patients with PsA, the mean Tender Joint Count was 9.1, and the mean Swollen Joint Count was 6.7. In the AS group, the mean Bath Ankylosing Spondylitis Disease Activity Index score was 4.6, and the mean Ankylosing Spondylitis Disease Activity Score was 3.7. The study demonstrates disease durations, disease activity, and treatment history in Thai patients that were generally consistent with previous randomized controlled studies. Long-term data on the efficacy and safety of the treatment will be presented in future publications.

Effects of Procedural Information, Buzzy, and Multiple Interventions on Pain in Children Undergoing Venipuncture: A Randomized Controlled Trial.

Needle-related procedures are commonly performed in childhood and lead to considerable pain. This randomized controlled study was conducted to compare the effects on venipuncture pain of the Buzzy, an informational animated video, multiple interventions, and standard care in children aged 6-12 years. One hundred eighty children were assigned to the groups using a computerized randomization program. Pain level was evaluated by the children, parents, and their nurses using the Wong-Baker Faces Pain Scale. The level of agreement among the nurse, parents, and children's pain reports was evaluated. Multivariable regression analysis was performed to identify the factors significantly associated with pain score. The participants in the Buzzy, video watching, and multiple intervention groups reported lower mean pain scores (child: KW = 28.24, p < .001; parent: KW = 18.51, p < .001; nurse: KW = 44.4, p < .001) than their peers in the control group. Moreover, age was identified as a risk factor affecting pain level (OR = 1.375, 95% CI [1.086, 1.740]; p = .008). Buzzy and informational videos are potentially effective methods to facilitate venipuncture-related pain management in children. The use of pain management methods during venipuncture is recommended, especially in children younger than 10 years old.

Music therapy improves engagement and initiation for autistic children with mild intellectual disabilities: A randomized controlled study.

This study aimed to evaluate the effectiveness of music therapy (MT) for children with co-occurring autism spectrum disorder (ASD) and intellectual disabilities (ID) and explore whether pre-intervention quantitative electroencephalogram (qEEG) responses can predict outcomes. A randomized controlled trial was conducted with 33 children receiving MT and 34 receiving an active control therapy. Participants received either MT or a non-musical social skills intervention for 45 min weekly over 12 weeks. Primary outcomes were measured using the Childhood Autism Rating Scale (CARS-2), along with the parent-rated Social Responsiveness Scale (SRS-2) and video coding of social behaviors. Both conditions significantly improved in CARS-2 scores at 2 weeks and 4 months post-intervention, with no differences between MT and control conditions. No changes were found in SRS-2 scores. While both conditions showed reduced disengagement after intervention, only the MT condition showed increased engagement and initiation. Strong qEEG responses to social scenes and music predicted increased initiation, indicating its potential to help tailor interventions. These results support incorporating MT into standard services and further research on qEEG predictors.

Effect of remimazolam on oxygen reserve compared with propofol during upper gastrointestinal endoscopy: Randomized controlled study.

Propofol is commonly used for endoscopic sedation. However, it can induce adverse hemodynamic effects. Remimazolam is known to have a fast onset and short duration comparable to that of propofol, but with fewer effects on hemodynamics. We assessed the Oxygen Reserve Index to verify whether a sedative dose of remimazolam would better preserve oxygenation in the mild hyperoxic range than propofol in sedated patients undergoing diagnostic upper gastrointestinal endoscopy. Patients scheduled for diagnostic upper gastrointestinal endoscopy were enrolled. Patients were randomly assigned to either the remimazolam or propofol groups and received 0.1 mg/kg remimazolam or 0.5 mg/kg propofol, respectively. Bolus injections of either 0.05 mg/kg remimazolam or 0.25 mg/kg propofol were added if required. The primary outcome was the prevalence of oxygen reserve depletion, defined as the Oxygen Reserve Index decreasing to 0.00, and hypoxia defined as peripheral oxygen saturation falling to <94%. Among 69 patients, the incidence of oxygen reserve depletion was significantly higher in the propofol group (65.7% vs. 38.2%, P = 0.022). Hypoxia was frequently observed in the propofol group, whereas none was observed in the remimazolam group (11.4% vs. 0%, P = 0.042). Additional sedative injections were frequently required to complete endoscopy in the propofol group. None of the patients in the remimazolam group required airway interventions. Nausea was frequent in the propofol group in the recovery room. Our results indicate that remimazolam is a safe and useful sedative for upper gastrointestinal endoscopy.

Effectiveness of smartphone-based music intervention on perinatal depression: protocol for a randomized controlled trial

BackgroundPerinatal depression has become a global public health issue with a high prevalence rate. Multiple studies have confirmed the effectiveness of music intervention. Still, the current form of offline intervention ignores issues such as convenient transportation and the stigma of diseases that pregnant women are concerned about, resulting in poor adherence. This randomized controlled study will evaluate the impact of music intervention on depression, anxiety, and stress in perinatal women through the WeChat application. In addition, the usability of the WeChat application and the adherence of PND women will also be evaluated.MethodsThis randomized, open, single-center parallel controlled trial randomly divided 110 women with perinatal depression who met the inclusion criteria into a smartphone-based music intervention group and usual care group in a 1:1 ratio. The main outcome measures will consist of EPDS and WeChat application usability score. The secondary outcome measures will consist of GAD-7, CPSS, and Knowledge-Attitude-Practice questionnaire scores.DiscussionThis study will test the effectiveness of music intervention based on the WeChat application for perinatal depression and the usability of the WeChat application, to provide practical guidance for perinatal mental health care.Trial RegistrationThis protocol was registered at the Chinese Clinical Trials.gov (Identifier: ChiCTR2400088924) on August 29, 2024.

Integrated Carbon Dioxide Capture by Amines and Conversion to Methane on Single-Atom Nickel Catalysts.

Direct electrochemical reduction of carbon dioxide (CO2) capture species, i.e., carbamate and (bi)carbonate, can be promising for CO2 capture and conversion from point-source, where the energetically demanding stripping step is bypassed. Here, we describe a class of atomically dispersed nickel (Ni) catalysts electrodeposited on various electrode surfaces that are shown to directly convert captured CO2 to methane (CH4). A detailed study employing X-ray photoelectron spectroscopy (XPS) and electron microscopy (EM) indicate that highly dispersed Ni atoms are uniquely active for converting capture species to CH4, and the activity of single-atom Ni is confirmed using control experiments with a molecularly defined Ni phthalocyanine catalyst supported on carbon nanotubes. Comparing the kinetics of various capture solutions obtained from hydroxide, ammonia, primary, secondary, and tertiary amines provide evidence that carbamate, rather than (bi)carbonate and/or dissolved CO2, is primarily responsible for CH4 production. This conclusion is supported by 13C nuclear magnetic resonance (NMR) spectroscopy of capture solutions as well as control experiments comparing reaction selectivity with and without CO2 purging. These findings are understood with the help of density functional theory (DFT) calculations showing that single-atom nickel (Ni) dispersed on gold (Au) is active for the direct reduction of carbamate, producing CH4 as the primary product. This is the first example of direct electrochemical conversion of carbamate to CH4, and the mechanism of this process provides new insight on the potential for integrated capture and conversion of CO2 directly to hydrocarbons.

Optimal design of neural network-based fuzzy predictive control model for recommending educational resources in the context of information technology

Abstract As the information technology develops, educational resource recommendation system has become an indispensable part of the education field. At the same time, people’s demand for personalised educational resources is also growing; therefore, how to accurately predict user demand and provide personalised recommendations has become an important issue. In this study, a fuzzy predictive control model on the grounds of neural network is proposed to optimise the design of educational resource recommendation in the context of information technology. After experimental testing, the model recommendation fit reached 95.16 and 92.91% on the two test datasets, which are significantly higher than the control model. The average F1 values of the proposed model also reached 95.21 and 88.77%, which are higher than the control model. In other control experiments, the proposed model of this study also has a better performance. The relevant outcomes showcase that the predictive performance and recommendation effect of the model can be further enhanced by improving the structure of the neural network and the parameter optimisation method. Meanwhile, the proposed model has high performance in information overload and personalised demand, which offers a useful reference for the optimal design of educational resource recommendation system.

The Effect of Ultrasound-Guided Erector Spinae Plane Block on Postoperative Opioid Consumption and Respiratory Recovery in Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Study.

The aim of this prospective, randomized, controlled study was to evaluate the effect of ultrasound (US)-guided bilateral erector spinae plane (ESP) block on postoperative opioid consumption and respiratory recovery in patients with obesity undergoing laparoscopic sleeve gastrectomy (LSG). The study was conducted on 40 patients scheduled for LSG. The patients were randomly allocated into either the ESP block group or the control group. The US-guided bilateral ESP block was performed preoperatively. The control group received no intervention. Postoperative median [IQR] tramadol consumption was significantly lower in the ESP block group [150.0 [100-200] mg vs 450.0 [400-500] mg, p < 0.0001]. Postoperative spirometric variables were significantly impaired in both groups, compared with preoperative variables (p < 0.0001). Intraoperative median [IQR] fentanyl consumption was 200.0 [200-200] µg in the ESP block group, and 350.0 [300-400] µg in the control group (p < 0.0001). Postoperative mean pain scores at rest and during movement were significantly lower in the ESP block group, at all time points (p < 0.05). In terms of mean arterial PH, Horowitz ratio, and PaCO2, there was no statistically significant difference between the groups (p > 0.05). None of the patients experienced postoperative respiratory adverse events and/or block-related complications. US-guided bilateral ESP block significantly reduced both intraoperative and postoperative analgesic consumptions and provided effective postoperative pain control for patients with obesity undergoing bariatric surgery. Following bariatric surgery, all patients' postoperative pulmonary functions deteriorated. The effect of US-guided bilateral ESP block on postoperative respiratory recovery could not be clearly demonstrated. Randomized controlled studies with a larger patient population are necessary.

Energy and protein nutrition adequacy in general wards among intensive care unit survivors: A systematic review and meta-analysis.

Adequate energy and protein provision is mandatory to optimize survival chances in critical illness, prevent loss of muscle mass, and reduce length of stay. Data are available concerning feeding adequacy in intensive care unit (ICU) participants, but little is known about the adequacy in post-ICU participants. This systematic review aimed to evaluate feeding adequacy in post-ICU participants and addressed causes of feeding interruption leading to suboptimal adequacy. For this systematic review, a bibliographic search was performed in PubMed, Scopus, and Web of Science. Randomized controlled studies, non-randomized controlled studies, and observational studies conducted between January 1990 and November 2023 fulfilling the inclusion criteria were withheld. Eight studies were included. Outcomes reported were energy and protein adequacy, barriers, and feeding routes. Energy and protein requirements were determined in various ways, including indirect calorimetry and standardized and weight-based formulas. Energy adequacy ranged from 52% to 102% and protein adequacy between 63% and 86%. Participants were mainly fed with enteral nutrition (EN) or a combination of oral nutrition and EN. The main barrier reported for inadequate nutrition intake was feeding tube removal. Next to different ways in calculating targets and reporting results, a wide range in energy and protein adequacy was observed, but with constant protein underfeeding. Participants fed with EN or a combination of EN and oral nutrition had the best adequacy; inappropriate tube removal is a common barrier leading to inadequate therapy. Standardized reporting and larger studies are needed to guide nutrition care for post-ICU participants.

Host-Guest Adduct as a Stimuli-Responsive Prodrug: Enzyme-Triggered Self-Assembly Process of a Short Peptide Within Mitochondria to Induce Cell Apoptosis.

To address the issue of nonspecific biodistribution of a chemotherapeutic drug, stable [2]pseudorotaxane complexes (PK@CAOPP and PR@CAOPP) are used to demonstrate a proof of concept. Cationic -PPh3 + moiety in CAOPP allows specific localization of the PK@CAOPP/ PR@CAOPP in the mitochondrial membrane (MM). Electrostatic interaction between the cationic LysinePK or ArgininePR moiety and the negatively charged phosphoesterCAOPP functionality in CAOPP favours strong adduct formation. The ALP-induced hydrolytic cleavage of the phosphoester moiety in cancer cells triggers dephosphorylation and releases PK/ PR moiety from PK@CAOPP/PR@CAOPP. PK or PR, derived from the Phe-Phe dipeptide, formed fibril-like molecular aggregates in the MM to induce dysfunction, depolarization, ROS generation and apoptotic MCF7 cell death. Such phenomena were not observed in ALP-negative HEK293 normal cells. These propositions were confirmed through control studies using NBDK and PE, other guest molecules. Smaller size and inclusion of the short peptides (PK or PR) within the hydrophobic interior of CAOPP, were attributed to their stability in blood serum. Thus, we have demonstrated the use of supramolecular adducts as a potential therapeutic option for treating cancer cells without affecting healthy cells. The efficacy was also established with an in-vivo MCF7 tumour xenograft model using Balb/c nude mice.

Photo-supported conversations about well-being (BeWellTM) for patients with exhaustion disorders – a controlled clinical intervention study

Introduction Health-promotion approaches to address stress-related exhaustion disorders, reduce personal suffering, improve coping and participation in everyday life are needed in primary care. The aim of this study was to investigate self-reported health and well-being before and after an intervention focusing on well-being with photo-supported conversations (BeWellTM). Material and methods Eighty-one patients (69 women), 20–67 years old, with exhaustion disorders were recruited at Swedish primary health care centres (PHCC) to a controlled clinical study. The intervention group (n = 40) were offered BeWell™ by therapists in addition to care as usual. Controls (n = 41) received only care as usual. The primary outcome, self-rated symptoms of exhaustion (Karolinska exhaustion disorder scale, KEDS), and secondary outcomes, anxiety and depression, sense of coherence, quality of life, occupational balance, and work ability, were assessed by validated questionnaires. Non-parametric statistical analyses were used to compare data collected directly after the treatment period with baseline measures. Results Demographics and self-rated baseline measures of health and well-being were comparable between the groups, apart from sick leave being more common in the intervention group. Participants in the intervention group reduced their level of exhaustion more than the control group (median difference on KEDS −9.0 vs −4.0, p = .035). However, the size of the KEDS reduction was related to baseline KEDS and, not independently associated with group assignment. Both groups improved regarding secondary outcome measures. Conclusion Stress-related symptoms decreased considerably over the treatment period for both groups. The potential benefit of the BeWell™, which was intended to facilitate recovery, needs to be further evaluated.

The overestimation of the effect sizes of psychotherapies for depression in waitlist controlled trials: a meta-analytic comparison with usual care controlled trials.

There is considerable evidence that waiting list (WL) control groups overestimate the effect sizes of psychotherapies for depression. It is not clear, however, what are the exact causes for this overestimation. We decided to conduct a meta-analytic study to compare trials on psychotherapy for depression with a WL control group against trials with a care-as-usual (CAU) control group. We used an existing meta-analytic database of randomized trials comparing psychological treatments of adult depression with control groups and selected trials using a WL or a CAU control group. We used subgroup and meta-regression analyses to examine differences in effect sizes between WL and CAU controlled trials. We included 333 randomized controlled trials (472 comparisons; total number participants: 41,480), 141 with a WL and 195 with a CAU control group (3 included both). We found several significant differences between WL and CAU controlled trials (in type of therapy examined, treatment format, recency, target group, recruitment strategy, number of treatment arms and number of depression outcome measures). The overall effect size indicating the difference between treatment and control at post-test for all comparisons was g = 0.77 (95% confidence interval [CI]: 0.71; 0.84) with high heterogeneity (I2 = 84; 95% CI: 82; 85). A highly significant difference was observed between studies with a CAU control group (g = 0.63; 95% CI: 0.55; 0.71; I2 = 85; 95% CI: 83; 86) and studies with a WL (g = 0.95; 95% CI: 0.85; 1.04; I2 = 80; 95% CI: 78; 82; p for difference < 0.001). This difference remained significant in all sensitivity analyses, including a meta-regression analysis in which we adjusted for all differences in characteristics of studies with a WL versus CAU control group. We also found that pre-post effect sizes in WL control conditions (g = 0.37; 95% CI: 0.28; 0.46) were significantly smaller than change within CAU conditions (g = 0.64; 95% CI: 0.50; 0.78). We found few indications that pre-post effect sizes within therapy conditions differed between WL and CAU controlled trials. WL control conditions considerably overestimate the effect sizes of psychological treatments, compared to trials using CAU control conditions. This overestimation is probably caused by a smaller improvement within the WL condition compared to the improvement in the CAU condition. WL control conditions should be avoided in randomized trials examining psychological treatments of adult depression.

Physical activity in the treatment-resistant depression and non-remitted depression: a systematic review of randomized controlled trials

Background The objective of this systematic review was to analyze the effects of physical activity (PA) intervention as an adjuvant strategy to pharmacological treatment in people with treatment-resistant depression (TRD) and non-remitted depression (NRD). Methods A search strategy was realized from five databases: PubMed, Cochrane Central Register of Controlled Trials, Scopus, SPORTDiscus, and Web of Science. The Physiotherapy Evidence Database and Oxford’s Evidence Levels were used to classify the quality appraisal. Results Of the 10777 records, 11 randomized controlled studies attained the inclusion criteria. The more significant outcome for this analysis was the improvement of depression by PA or exercise in TRD and NRD. According to the FITT (Frequency, Intensity, Time, and Type) principle, there was some variability in the PA intervention, and except for one article, they all were classified as excellent in terms of quality description. Conclusions This review highlights the potential of PA intervention as an adjuvant program to improve different traits of TRD and NRD. The remission of depression seems to be higher after PA intervention, showing improvements in quality of life, sleep quality, executive function, and vitality.

The effect and safety of corticosteroid treatment for severe community-acquired pneumonia: a meta-analysis of randomized controlled trials

BackgroundThere is ongoing debate on the efficacy and safety of corticosteroid therapy for severe community-acquired pneumonia (sCAP). Our aim was to investigate the safety and therapeutic effectiveness of corticosteroids in the sCAP therapy.MethodsElectronic databases (Cochrane Library, PubMed, Web of Science and Embase) were searched from inception to January 10, 2024. We examined for randomized controlled studies assessing the effectiveness and safety of corticosteroid therapy in individuals with sCAP. The primary outcome was short-term mortality. Subgroup analyses were carried out according to the corticosteroid type. Additionally, trial sequential analysis (TSA) was carried out.ResultsIn total, 11 trials, including 1959 patients, met the predetermined standards and underwent analysis. Overall, our meta-analysis exhibited that corticosteroids may considerably lower short-term mortality when compared to control treatment [6 studies (1,582 patients); odds ratio (OR), 0.65; 95% confidence interval (CI) 0.49–0.88; p = 0.005] and C-reactive protein (CRP) levels [5 studies (359 patients); mean difference (MD), −6.97; 95% CI −12.33 to −1.60; p = 0.01], but TSA revealed that the sample size needs to be larger. Moreover, we observed that corticosteroids reduced the hospital length of stay [7 studies (999 patients); MD, −3.56; 95% CI, −4.28 to −2.84; p &amp;lt; 0.001], need for mechanical ventilation (MV) [7 studies (1,328 patients); OR, 0.60; 95% CI, 0.45–0.79; p = 0.001] and MV duration [4 studies (736 patients); MD, −5.62; 95% CI, −7.31 to −3.94; p &amp;lt; 0.001], which was in agreement with TSA. However, adverse events, length of hospital and intensive care unit (ICU) stay were not evidently shortened when TSA was utilized. Furthermore, subgroup analysis revealed that all of the above studies benefited from hydrocortisone treatment in comparison to the control group.ConclusionOur meta-analysis revealed that corticosteroids, especially hydrocortisone, could decrease the mortality of individuals with sCAP.Systematic review registration[https://clinicaltrials.gov/], identifier [CRD42023415555].