Effect Of Daily Use Research Articles

Early changes in the gut microbiome among HIV-infected Individuals in Uganda initiating daily TMP/SMX.

Daily cotrimoxazole (TMP/SXT) prophylaxis is part of the HIV treatment package for all new HIV-infected individuals in Uganda. Although this treatment has shown reduced morbidity and mortality in HIV, it remains controversial due to its contribution to developing antibiotic-resistant bacteria. Moreover, the effects of daily use of a broad-spectrum antibiotic on the gut microbiome remain unknown. To study the early effects, we analysed shotgun metagenome sequence data from stool samples of five newly HIV-infected individuals initiating TMP/SXT prophylaxis longitudinally for the first 30 days of treatment. Using shotgun metagenomics sequencing, we generated both taxonomic and functional profiles from each patient and compared gut microbial changes Pre-TMP/SXT and post-TMP/SXT on Day 5, Day 14, and Day 30. Daily TMP/SXT prophylaxis resulted in a shift characterised by an enrichment of Prevetollea and Ruminococcus genera members and the depletion of Lactococcus and Bacteroides genera members. Furthermore, these microbial shifts were associated with changes in the functional profile revealed by a differential abundance of pathways of amino acid metabolism, carbohydrate metabolism, and nucleotide biosynthesis linked to members of the Bacteroidaceae and Enterobacteriaceae families. TMP/SXT daily prophylaxis in HIV-infected individuals is associated with dramatic changes in microbial composition and functional profiles; however, other factors such as Age, Gender, HIV clinical stage, and ART regiment are at play. Further investigation is needed to examine the implication of these shifts on clinical management and outcomes among HIV patients.

The efficacy and safety of an enzyme-containing lozenge for dental biofilm control—a randomized controlled pilot trial

ObjectivesTo evaluate the effect of daily use of a multiple-enzyme lozenge on de novo plaque formation, on gingivitis development, and on the oral microbiome composition. MethodsThis trial with two parallel arms included 24 healthy adults allocated to the Active (n = 12) or Placebo (n = 12) group. Subjects consumed one lozenge three times daily for seven days, and no oral hygiene procedures were allowed. Differences in de novo plaque accumulation between a baseline period, and one and seven days of intervention were assessed by the Turesky-modification of the Quigley-and-Hein-Plaque-Index (TM-QHPI). The development of gingivitis after seven days of intervention was assessed by the Gingival Index (GI). Plaque and saliva samples were collected at baseline and after seven days of intervention, and evaluated by 16S rRNA gene sequencing. ResultsAll subjects completed the study, and no adverse events were reported. After one day, the average TM-QHPI was significantly lower in the Active than in the Placebo group, as compared to baseline (p = 0.012). After 7 days, average TM-QHPI values did not differ significantly between groups (p = 0.37). GI values did not increase during the intervention period, with no difference between groups (p = 0.62). Bacterial richness increased in both plaque and saliva samples over a seven-day oral hygiene-free period, with a statistically significant difference for the saliva samples (p = 0.0495) between groups. ConclusionsA multiple-enzymes lozenge decreased the build-up of de novo plaque after one day and slowed down the process of species increment in saliva. The lozenge may be an adjunct to regular mechanical plaque removal. Clinical significanceDental plaque is the main cause of caries, gingivitis, and periodontitis. The search for therapeutic adjuncts to mechanical plaque removal that have no harmful effects on the oral microbiome is important. Treatment with multiple plaque-matrix degrading enzymes is a promising non-biocidal approach to plaque control.

Virucidal effect of mouthwash on acyclovir-resistant herpes simplex virus.

The symptoms of herpes simplex viruses type 1 (HSV-1) infections might be severe and persistent in immunocompromised patients in whom they reactivate at a high frequency. The development of Acyclovir (ACV) resistant strains due to long-term treatment with antiviral agents in those patients is not uncommon. The aim of the present study was to assess the virucidal effect of commercially available mouthwashes against ACV-resistant HSV-1 strains. Two acyclovir-resistant HSV-1 strains were exposed for 30 s to essential oil-based (Listerine Fresh Burst® and Listerine Zero®), chlorhexidine gluconate 0.2% (Hexidyl®) and povidone-iodine 7.5% (Betadine Gargle®) mouthwashes. Loss of virus infectivity was determined by means of plaque reduction assays in a cell culture system. All 4 of the tested solutions significantly reduced virus infectivity, with the essential oil-based and povidone-iodine mouthwashes being slightly more efficacious, compared to chlorhexidine. The findings of this analysis revealed that the tested oral rinses demonstrated in-vitro antiviral activity against ACV-resistant HSV. Comparative clinical trials are required to establish the clinical effectiveness of daily use of oral rinses in reducing the appearance of oral HSV lesions in immunocompromised patients.

Is daily emotion suppression associated with poor sleep? The moderating role of culture.

Emotion suppression is widely assumed to be unhealthy. Yet, this conclusion may be limited to independent Western cultures that value self-expression. In a pre-registered, daily diary study of European American and East Asian college students, we tested whether culture moderates the effects of daily use of emotion suppression on sleep-a critical component of healthy living among young adults. A total of 117 college students (62 European Americans and 55 East Asians) completed two diaries per day for 14 days to assess (a) their daily use of emotion suppression every night and (b) subjective sleep quality and mood upon awakening every morning. Participants also wore actigraphy watches to provide behavioral measures of sleep. The data were collected between 2018 and 2020. We used multilevel models to test cultural differences in the effects of emotion suppression on sleep and mood measures at both between-person (average) and within-person (day-to-day) levels. For European Americans, greater use of emotion suppression across 2 weeks was associated with lower average subjective sleep quality and more tense (vs. calm) feelings upon awakening. At the within-person level, on days when European Americans used emotion suppression more than usual, they had less amount of sleep that night. In contrast, these associations were completely absent among East Asians. These results provide support for the cultural fit hypothesis that how emotion suppression affects sleep health varies by cultural contexts, depending on whether this regulatory behavior is normatively congruous or incongruous with the values prioritized in each culture. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The effect of a lozenge combining prebiotic arginine and probiotics on caries increment in children during 10–12 months, a randomized clinical trial

ObjectivesTo investigate the effect of daily use of a lozenge containing arginine and probiotics for 10–12 months on caries increment, gingivitis- and plaque occurrence in children aged 5–9 years. MethodsIn this placebo-controlled, double-blinded, parallel-grouped randomized clinical trial, 343 children were randomly assigned to one of the study arms (1:1). The intervention group (n = 172) received a lozenge containing Lacticaseibacillus rhamnosus, LGG® (DSM33156), Lactobacillus paracasei subsp. paracasei, L. CASEI 431® (DSM33451) and prebiotic (arginine 2%). The placebo group (n = 171) received an identical lozenge without arginine or probiotics. Primary canines and molars, and permanent first molars were examined clinically (d/D= ICDAS1–6) and radiographically (d/D = R1–6) at baseline and follow-up. Missing (m/M), sealed (s/S), and filled (f/F) surfaces (-s/-S) in both dentitions were also included. Utilizing clinical and radiographic scorings, caries experience was classified as dICDAS1–6msf-s (primary teeth), DICDAS1–6MSF-S (permanent teeth), d/DICDAS1–6 m/M-s/S-f/F-s/S (mixed dentition). A weighted and an unweighted score system was applied. ResultsThe study was completed by 288 children. The dropout rate was 15%. The increase in ∆mean dICDAS3–6msf-s and ∆mean d/DICDAS3–6m/M-s/S-f/F-s/S was lower in the intervention group (p = 0.007). No differences were found for gingivitis- and plaque occurrence. No product-related side effects were reported. This study followed ICH-GCP including external monitoring. ConclusionDaily consumption of a lozenge containing prebiotic arginine and two strains of probiotics showed safe use and statistically significantly reduction in caries incrementbut no effect on the mean plaque or gingivitis occurrence in children. The use of a lozenge with arginine and probiotics combined has a promising potential as a supplementary tool for future management of caries. www.ClinicalTrials.gov (NCT03928587). Clinical significanceThe combination of prebiotic arginine and probiotics shows clinical potential as a supplementary approach to toothbrushing with fluoride toothpaste in managing caries increment in children. A new era in the management of caries may be emerging.

Effect of daily use of Lavender (Lavandula angustifolia) and Cedarwood (Cedrus atlantica) essential oils on nocturnal anxiety and respiratory disorders: a case report

Aromatherapy is a healing practice that has been used for centuries to promote physical and psychological wellbeing. The practice involves the use of essential oils (EOs) extracted from plants to treat a variety of conditions. Aromatherapy is believed to work by stimulating the sense of smell and the limbic system of the brain, which is responsible for emotions, memories, and learning. Lavender (Lavandula angustifolia) is a safe essential oil with well-established sedative and hypnotic properties Additionally, the properties of essential oils obtained from different species of Cedrus, such as C. atlantica, have been reported for their use in aromatherapy to obtain many clinical benefits traditionally attributed to the genitourinary, musculoskeletal, and cutaneous systems. However, the role of essential oil in the treatment of nocturnal anxiety and respiratory disorders in sleep is unclear, which makes clinical studies necessary to reinforce this hypothesis. Here, we present a clinical case of an adult patient with daily anxiety attacks and nocturnal breathing disorders effectively treated with the inhaled use of essential oil of Lavender (Lavandula angustifolia) and Cedarwood (Cedrus atlantica).

Investigation of the anti-oxidative and anti-inflammatory effects of melatonin on experimental liver damage by radiation.

Radiotherapy is one of the inevitable treatment approaches for several types of cancer. We aimed to show the protective and therapeutic effects of daily use of melatonin on liver tissues subjected to a single dose of 10Gy (gamma-ray) total body radiation. Rats were divided into 6 groups, of which 10 were in each: control, sham, melatonin, radiation, radiation+melatonin, and melatonin+radiation. The rats received 10 Gy of external radiation throughout their entire bodies. The rats were given 10 mg/kg/day of melatonin intraperitoneally before or after radiation treatment, depending on the group. Histological methods, immunohistochemical analysis (Caspase-3, Sirtuin-1, α-SMA, NFΚB-p65), biochemical analysis by ELİSA (SOD, CAT, GSH-PX, MDA, TNF-α, TGF-β, PDGF, PGC-1α) and the Comet assay as a marker of DNA damage were applied to the liver tissues. Histopathological examinations showed structural changes in the liver tissue of the radiation group. Radiation treatment increased the immunoreactivity of Caspase-3, Sirtuin-1 and α-SMA, but these effects were relatively attenuated in the melatonin-treated groups. The melatonin+radiation group had statistically significant results close to those of the control group, in terms of Caspase-3, NFΚB-p65 and Sirtuin-1 immunoreactivity. In melatonin treated groups, hepatic biochemical markers, MDA, SOD, TNF-α, TGF-β levels, and DNA damage parameters were decreased. Administration of melatonin before and after radiation has beneficial effects, but using it before radiation may be more efficient. Accordingly, daily melatonin usage could mitigate ionizing radiation induced damage.

Companion robot can be a health keeper for the elderly: The effects of daily use of companion robot on medication compliance

Companion robot can be a health keeper for the elderly: The effects of daily use of companion robot on medication compliance

34428 Clinical and biophysical assessment of the effects of daily use of a nature-based, broad-spectrum mineral sunscreen containing bakuchiol in photoaged skin

Background: Skin exposure to ultraviolet radiation causes disruption of fibroblast-extracellular matrix interactions causing loss of/damage to collagen, decreased fibroblast cell density and morphology and degeneration of the elastic fiber network. These result in clinical degenerative changes such as wrinkles, sallow complexion and loss of hydration and elasticity. We developed a photostable, broad-spectrum SPF 30 product with inorganic sunscreen actives and a natural retinol alternative, bakuchiol. Objective: To investigate the effects of a nature-based mineral broad-spectrum sunscreen to improve clinical outcomes of photodamaged skin. Methods: A single-center, open-label study was performed on 49 female subjects aged 35 to 60 years with mild to moderate signs of photodamage. Evaluations of the nature-based sunscreen product were made at baseline and at week 6 after twice daily minimum topical application on the face. The dermatologist investigator and subjects assessed efficacy and tolerability using a 5-point ordinal scale (0 = none, 4 = severe). Noninvasive measurements of skin hydration, barrier function and elasticity were conducted. Results: Investigator clinical evaluations showed significant improvements in skin laxity, fine lines, smoothness, pigmentation, and texture. Subject-rated change from baseline demonstrated similar efficacy as the investigator. Skin hydration significantly improved by 21%. A significant 32% decrease in the retraction time (ms) was measured after 6 weeks of product use, indicating improved skin elasticity. There was no disruption to skin barrier function. No tolerability related issues were observed during study duration. Conclusion: Daily photoprotection using a nature-based broad-spectrum mineral sunscreen containing bakuchiol visibly improved the signs of photodamage and the skin’s biophysical properties.

Clinical effect of the combination of myoinositol and D-chiroinositol in the ratio 5:1 with manganese and folic acid on female reproductive function in patients with anovulatory infertility in patients with abnormal menstrual cycles and obesity

Aim. Effect of daily use of the combination of myoinositol and D-chiroinositol with manganese and folic acid (Dikirogen) on the onset of a regular menstrual cycle, ovulation, pregnancy, tolerance and satisfaction of the study participants.
 Materials and methods. The study involved 60 women aged 40 years and younger, the average age was 30,933,79 years. Duration of taking Dikirogen was 1703 days, participants observation was 1803 days. Body mass index, waist circumference (WC), ultrasound of the pelvic organs and ovaries, assessment of hirsutism (Ferryman-Gallway scale), acne severity (Cook questionnaire), depressive symptoms (Hamilton scale), quality of life (SF36 questionnaire) were performed during the study.
 Results. The pregnancy rate at the end of the study was 31.7%. During the daily using of the Dikirogen, there was a decrease in WC (p=0,007), the severity of acne (p=0,002) and the number of points on the Hamilton scale (p=0,04). Also there was a increase in the number of points on the SF36 questionnaire (p=0,0001). 93.33% of the woman has been reported that the Dikirogen was well tolerated.
 Conclusion. Dikirogen is an optimal doses chemical composition, selected taking into account the synergism of the components and the daily requirement, and it is effective in treatment for women with anovulatory infertility.

Evaluating the effects of a mindfulness mobile application on student pharmacists' stress, burnout, and mindfulness.

Pharmacists report high levels of burnout. Mindfulness approaches have been demonstrated to have positive results in the general population and in other healthcare professions. However, limited studies have been performed evaluating mindfulness approaches in student pharmacists. The aim of this study was to evaluate the effectiveness of daily use of a mindfulness mobile application in improving student pharmacists' perceived stress, burnout, and mindfulness. This study was a randomized, longitudinal, waitlist-controlled trial. The intervention group was asked to meditate using the mindfulness application Headspace daily for at least 6 weeks. The waitlist control group was asked to abstain from using the application for the entire study. Stress, burnout, and mindfulness were assessed using validated survey instruments at baseline, 6 weeks, and 10 weeks. A secondary outcome was to assess the persistence of application use after the intervention period. Fifty-six participants completed the study. The intervention group reported significantly lower scores on stress and burnout at 6 weeks compared to the control group. The intervention group also reported significantly higher scores on mindfulness. The differences in stress, burnout, and mindfulness persisted at follow-up. The mean percentage of students in the intervention group who used the application each day was 90% over the intervention period and 62% over the follow-up period. A mindfulness mobile application significantly improved student pharmacists' stress, burnout, and mindfulness with daily use. Most participants continued to use the application for 4 weeks after the end of the intervention. Positive effects on stress and mindfulness persisted even with decreased use.

Effects of fake and original perfumes on the presence, numbers, and distribution of mast cells in selected tissues in rats.

Background: Perfumes, whether original or fake, are considered of great economic value. However, overzealous use of perfumes could be associated with local or systemic side effects. Aim:This study was conducted to investigate the effects of daily use of original and fake perfumes on numbers and distribution of mast cells in several organs and tissues of Wistar rats. Methods:Three different kinds of original perfumes coded as O1, O2, and O3 and their fake counterparts coded as F1, F2, and F3 were applied once daily directly on the skin of rats for 28 consecutive days. At the end of the study, representative tissue samples were taken and processed for histopathological examination using Hematoxylin and Eosin, toluidine blue, and Wright’s stains. Results:A significant (p < 0.05) elevation in mast cell count was observed in F3, O3, F1, and F2 compared to the control group. The majority of mast cells were distributed in the hepatic perivascular tissues, peribronchial and pleural tissues. There was a significant (p < 0.05) elevation in mast cell count in along the interalveolar wall, peribronchial area, and pleura tissues in F1 and O3 groups.Conclusion:Results of this study indicated that repeated use of both original and fake perfumes was associated with an increased number of mast cells in different body organs and tissues.

Design of the DYNAMO study: a multi-center randomized controlled trial to investigate the effect of pre-thickened oral nutritional supplements in nursing home residents with dysphagia and malnutrition (risk)

BackgroundOropharyngeal Dysphagia (OD) and malnutrition are frequently reported conditions in nursing home residents, and are often interrelated. Best care for dysphagic residents with, or at risk of, malnutrition should target adequate nutritional intake and the safety and efficacy of swallowing. The effect of oral nutritional supplements (ONS) suitable for nursing home residents with concurrent OD and malnutrition (risk) on nutritional status has not been investigated before. The current study aims to investigate the effect of daily use of a range of pre-thickened ONS on the body weight of nursing home residents with OD and malnutrition (risk) compared to standard OD and nutritional care.Methods / designThe DYNAMO study is a randomized, controlled, multi-center, open label trial with two parallel groups. Study participants will be recruited in nursing homes of several care organizations in the south of the Netherlands. Study duration is 12 weeks. Residents in the control group will receive standard OD and nutritional care, and residents in the test group will receive standard OD and nutritional care with extra daily supplementation of pre-thickened ONS.The main outcome parameter is the difference in body weight change between the control and test groups. An a priori estimation of the required sample size per group (control / test) totals 78. Other outcome parameters are differences in: nutritional intake, health-related quality of life, OD-specific quality of life, activities of daily living, vital signs, and blood nutrient and metabolite levels.DiscussionRegular ONS could address the nutritional needs of nursing home residents with malnutrition (risk), but might be too thin and unsafe for residents with OD. Pre-thickened ONS is suitable for residents with OD. It offers the advantage of being a ready-to-use amylase-resistant product available in several consistencies which are able to increase swallowing efficacy and safety. The DYNAMO study is the first to investigate the effects of pre-thickened ONS on nutritional status in nursing home residents with concurrent OD and malnutrition (risk).Trial registrationNetherlands Trial Register (NTR): NTR NL7898. Registered 24 July 2019, https://www.trialregister.nl/trial/7898

Effect of daily use of fluoridated dentifrice and bleaching gels containing calcium, fluoride, or trimetaphosphate on enamel hardness: an in vitro study.

This study evaluated the effects of calcium gluconate (CaGlu), sodium fluoride (NaF), sodium trimetaphosphate (TMP), and NaF/TMP added to a 35% hydrogen peroxide (HP) bleaching gel for the reduction in enamel demineralization in vitro, with and without the use of a fluoridated dentifrice. Enamel blocks (n = 100) were obtained from bovine incisors (n = 200) after flattening and subjected to initial surface hardness (SH) analysis. The blocks were divided according to the bleaching gel (35% HP; 35% HP + 0.05% NaF; 35% HP + 0.25% TMP; 35% HP + 0.05% NaF + 0.25% TMP; 35% HP + 2% CaGlu) and were treated with ether non-fluoridated or fluoridated (1100ppm) dentifrice. The bleaching gels were applied thrice (40min/session) at the intervals of 7days between each application. After 21days, the final SH for the calculation of the percentage of SH loss (%SH) and cross-sectional hardness for the evaluation of the integrated hardness area (IH) were determined. Bleaching containing HP + NaF + TMP presented lowest %SH (p < 0.001), regardless of the dentifrice used. HP + NaF + TMP bleaching gel led to lower subsurface enamel mineral loss (IH) compared to the other groups (p < 0.001), and these did not differ from each other (p > 0.05). Daily use of fluoride dentifrice led to higher IH values (p < 0.001), regardless of the bleaching gels. The addition of NaF/TMP to a 35% HP bleaching gel remarkably reduced the mineral loss compared to the cases of the other bleaching gels, regardless of dentifrice. The association of TMP/NaF can be used as a strategy for reducing mineral loss during the bleaching procedure, even without the daily use of fluoride dentifrice.

Effects of chronic type 5 phosphodiesterase inhibition on penile microvascular reactivity in hypertensive patients with erectile dysfunction: a randomized crossover placebo-controlled trial.

This randomized crossover and placebo-controlled trial evaluated the effects of daily use of sildenafil citrate (SIL, 1-month 50 mg twice daily) on penile and systemic endothelial microvascular function in hypertensive patients presenting with erectile dysfunction. The effects of SIL on arterial pressure were evaluated using ambulatory blood pressure monitoring (ABPM). Fifty patients diagnosed with primary arterial hypertension and erectile dysfunction (aged 57.4 ± 5.6 years), recruited in a tertiary public hospital, were treated with SIL (50 mg twice daily) or placebo (PLA) for two 30-day periods with a 30-day washout between them. Laser speckle contrast imaging coupled with acetylcholine skin iontophoresis was used to evaluate penile and systemic (forearm) cutaneous microvascular reactivity. SIL treatment increased penile basal microvascular flow (P = 0.002) and maximal endothelial-dependent peak response to skin iontophoresis of acetylcholine (ACh, P = 0.006). The area under the curve of microvascular vasodilation induced by ACh was also significantly increased (P = 0.02). Lastly, SIL treatment did not modify systemic microvascular reactivity. Twenty-four-hour ABPM (P = 0.0002) and daytime (P = 0.002) and nighttime (P = 0.001) mean diastolic blood pressure values were significantly reduced after SIL treatment. The scores of the Simplified International Index of Erectile Function (P < 0.0001) and the number of patients with positive responses to Sexual Encounter Profile question 3 (P < 0.0001) also increased after SIL treatment. Penile endothelium-dependent microvascular reactivity improved after continuous use of sildenafil in hypertensive patients with erectile dysfunction; the treatment also reduced blood pressure, suggesting that, in addition to improving erectile function, daily use of sildenafil could improve blood pressure control.

Effect of Daily Use on Microstructure and Filtration Efficiency of Disposable Medical Face Masks

Effect of Daily Use on Microstructure and Filtration Efficiency of Disposable Medical Face Masks

Effectiveness of the short-term use of Cimicifuga racemosa in the endothelial function of postmenopausal women: a double-blind, randomized, controlled trial

Objective: This study aimed to assess the effects of daily use of Cimicifuga racemosa on endothelial function through flow-mediated dilation of the brachial artery, when used for 28 days by healthy postmenopausal women.Methods: The double-blind, randomized, placebo-controlled study included two groups of postmenopausal women (n = 31 each). The subjects were clinically assessed and flow-mediated dilation of the brachial artery was measured before and after 28 days of treatment. Patients received dry extract corresponding to 160 mg C. racemosa (extract with 4 mg of triterpene glycosides) or placebo.Results: Mean age, time since menopause, and body mass index in the two groups were similar. The measurements of flow-mediated dilation of the brachial artery, pre and post treatment, respectively, showed a significant increase in patients who used C. racemosa (p = 0.006), unlike patients who used placebo, who did not present changes in the outcome of flow-mediated dilation of the brachial artery after 28 days of use (p ≥ 0.05). When comparing the number of women in both groups who showed an increase in flow-mediated dilation, a significant difference was found in the measurements of the treated group after the use of the medication (p = 0.018).Conclusions: Daily use of 160 mg C. racemosa extract by postmenopausal women for 28 days beneficially influences endothelial function by promoting elasticity of the brachial artery.

Does mechanical stress cause microplastic release from plastic water bottles?

Plastic particle ingestion has become of concern as a possible threat to human health. Previous works have already explored the presence of microplastic (MP) in bottled drinking water as a source of MP intake. Here, we consider the release of MP particles from single-use PET mineral water bottles upon exposure to mechanical stress utilizing SEM plus EDS, which allows the implementation of morphological and elemental analysis of the plastic material surface and quantification of particle concentrations in sample water. The aim of this study was to better evaluate the sources of MP intake from plastic bottles, especially considering the effect of daily use on these bottles such as the abrasion of the plastic material. For that, we analysed MP release of PET bottlenecks and HDPE caps on their surfaces after a series of bottle openings/closings (1 x, 10 x, 100 x). Furthermore, we investigated, if the inner surface of the PET bottles released MPs, counted particle increase of the water and identified MPs in the PET bottled water after exposing the bottles to mechanical stress (squeezing treatment; none, 1 min, 10 min). The results showed a considerable increase of MP particle occurrence on the surface of PET and HDPE material (bottlenecks and caps) after opening and closing the bottles. After 100 times the effect was impressive, especially on caps. Moreover, great differences exist in cap abrasion between brands which uncovers a discrepancy in plastic behavior of brands. Interestingly, particle concentrations in the bottled mineral water did not significantly increase after exposure to mechanical stress (squeezing treatment). The morphological analysis of the inner wall surface of the bottles supported this observation, as no stress cracks could be detected after the treatment, implying that the bottles itself are not a consistent source of MP particles after this extent of mechanical stress. However, chances of MP ingestion by humans increase with frequent use of the same single-use plastic bottle, though only from the bottleneck-cap system.

Effectiveness of Daily Use of Bilateral Custom-Made Ankle-Foot Orthoses on Balance, Fear of Falling, and Physical Activity in Older Adults: A Randomized Controlled Trial

Background: Foot problems are prevalent in older adults, which may increase the risk and concern for falls. Ankle-foot orthoses (AFO) have been shown to be effective in the stabilization of lower extremities, but their long-term effectiveness in improving balance and their potential to encourage older adults to become more physically active are still debated. Objective: This randomized controlled trial investigated the effectiveness of daily use of a custom-made AFO on balance, fear of falling, and physical activity in older adults. Study Design: Forty-four older adults with concern about or at risk for falling were randomly allocated to either the control group (CG; 77.3% female, age 75.6 ± 6.5 years, BMI 29.3 ± 6.4) or the intervention group (IG; 63.6% female, age 73.7 ± 6.3 years, BMI = 27.8 ± 4.8). The IG received walking shoes and bilateral custom-made AFO. The CG received only walking shoes. At the baseline and 6-month follow-ups, balance and physical activity were assessed using validated wearable instrumentation and fear of falling was assessed using the Fall Efficacy Scale-International (FES-I). Adherence and acceptability toward wearing the AFO were assessed using self-reported questionnaires at the 6-month follow-up. Results: No significant between-group difference was observed at baseline (p = 0.144–0.882). Compared to baseline and the CG, hip, ankle, and center-of-mass (COM) sways were significantly reduced at the 6-month follow-up in the IG while standing with the feet together during the eyes-open condition (p = 0.005–0.040). Within the IG, the FES-I was reduced significantly (p = 0.036) and there was an increasing trend in the number of walking bouts with a medium effect size (d = 0.52, p = 0.440) compared to baseline. However, there were no significant changes in FES-I and physical activity measures in the CG (p = 0.122–0.894). The reduction in COM sway in the IG was moderately correlated with adherence (r = –0.484, p = 0.047) and strongly correlated with baseline COM sway (r = –0.903, p < 0.001). Conclusion: Results suggest that bilateral custom-made AFO plus walking shoes is effective in improving balance compared to walking shoes alone, and it significantly reduces the fear of falling, with a nonsignificant but noticeable positive trend in physical activity, compared to baseline. The results also suggest that older adults with poor balance at baseline and higher daily adherence to using the AFO will gain more benefit from the AFO intervention.

Footwear for self-managing knee osteoarthritis symptoms: protocol for the Footstep randomised controlled trial

BackgroundKnee osteoarthritis (OA) is a leading cause of musculoskeletal pain and disability globally, and abnormal knee loading is central to disease pathogenesis. Clinical guidelines recommend clinicians provide advice regarding appropriate footwear for people with knee OA, yet there is little research comparing the effects of different footwear on knee OA symptoms. Research suggests that wearing flat flexible shoes is associated with lower knee joint loads compared to stable supportive shoe styles. This two-arm pragmatic, comparative effectiveness randomised controlled trial will compare the effects of daily use of flat flexible shoes and stable supportive shoes on knee OA clinical outcomes, over 6 months.Methods164 people with symptomatic medial tibiofemoral OA of moderate to severe radiographic severity (Kellgren and Lawrence Grade 3 & 4) will be recruited from the community. Following baseline assessment, participants will be randomly allocated to receive either i) flat flexible shoes or; ii) stable supportive shoes. Participants will choose two different pairs of shoes from a selection that fulfil the criteria in their allocated shoe class. Limited disclosure will blind participants to group allocation. Participants will be instructed to wear their allocated shoes daily for 6 months (minimum of 6 h/day), after which participants will be reassessed. The primary outcomes are knee pain severity on walking (measured by numerical rating scale) and self-reported physical function (measured by the Western Ontario and McMaster Universities Osteoarthritis Index), assessed at baseline and 6 months. Secondary outcomes include additional measures of knee pain, function, sport and recreation participation and quality-of-life (measured using subscales of the Knee Osteoarthritis Outcome Score), as well as pain at other sites (measured by numerical rating scale), self-reported global ratings of change in pain and physical function (measured by 7-point rating scale), and physical activity levels (measured by Physical Activity Scale for the Elderly).DiscussionThis study will determine whether daily wear of flat flexible shoes improves clinical outcomes in the management of knee OA, compared to stable supportive shoes. Findings will assist clinicians in providing evidence-based advice regarding appropriate footwear for people with knee OA to self-manage symptoms.Trial registrationAustralian New Zealand Clinical Trials Registry reference: ACTRN12617001098325. Registered 28/07/2017.