Intervention Options Research Articles

Advancing Neuroscience and Therapy: Insights into Genetic and Non-Genetic Neuromodulation Approaches

Neuromodulation stands as a cutting-edge approach in the fields of neuroscience and therapeutic intervention typically involving the regulation of neural activity through physical and chemical stimuli. The purpose of this review is to provide an overview and evaluation of different neuromodulation techniques, anticipating a clearer understanding of the future developmental trajectories and the challenges faced within the domain of neuromodulation that can be achieved. This review categorizes neuromodulation techniques into genetic neuromodulation methods (including optogenetics, chemogenetics, sonogenetics, and magnetogenetics) and non-genetic neuromodulation methods (including deep brain stimulation, transcranial magnetic stimulation, transcranial direct current stimulation, transcranial ultrasound stimulation, photobiomodulation therapy, infrared neuromodulation, electromagnetic stimulation, sensory stimulation therapy, and multi-physical-factor stimulation techniques). By systematically evaluating the principles, mechanisms, advantages, limitations, and efficacy in modulating neuronal activity and the potential applications in interventions of neurological disorders of these neuromodulation techniques, a comprehensive picture is gradually emerging regarding the advantages and challenges of neuromodulation techniques, their developmental trajectory, and their potential clinical applications. This review highlights significant advancements in applying these techniques to treat neurological and psychiatric disorders. Genetic methods, such as sonogenetics and magnetogenetics, have demonstrated high specificity and temporal precision in targeting neuronal populations, while non-genetic methods, such as transcranial magnetic stimulation and photobiomodulation therapy, offer noninvasive and versatile clinical intervention options. The transformative potential of these neuromodulation techniques in neuroscience research and clinical practice is underscored, emphasizing the need for integration and innovation in technologies, the optimization of delivery methods, the improvement of mediums, and the evaluation of toxicity to fully harness their therapeutic potential.

Review: Animal-assisted intervention for children with attention-deficit/hyperactivity disorder - a systematic review and meta-analysis.

Animal-assisted interventions (AAIs) have emerged as a promising nonpharmacological intervention option for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). However, recent systematic reviews have been primarily narrative. Additionally, the pooled effectiveness of AAIs was absent from these systematic reviews. We conducted a comprehensive systematic review and meta-analysis, searching multiple databases, including Web of Science, MEDLINE, CINAHL, Scopus, PsycINFO, EMBASE and Cochrane, from inception of the databases to March 2024. We retrieved 17 randomised controlled trials or quasi-experimental studies and used Review Manager 5.4.1 software to perform a meta-analysis of the effects of AAIs in treating children with ADHD. We conducted a set of random-effects meta-analyses to estimate standardised mean differences (SMD) with 95% confidence intervals (CI) using subgroup data by different outcome domains extracted from eight randomised controlled trials, in relation to changes in behavioural, mental and physical functioning in a total of 307 children with ADHD before and after the intervention. In comparison with non-AAI groups, AAIs significantly improved attention problems in children with ADHD (SMD = -0.42, 95% CI = -0.71 to -0.13), self-esteem (0.46, 0.14 to 0.78), learning and cognition problems (-0.69, -0.98 to -0.39) and motor proficiency (0.77, 0.11 to 1.42). The pooled effect of AAIs on the severity of ADHD symptoms in the experimental group was not significantly different from the effect of conventional treatments in the control group (0.10, -0.31 to 0.52). Similarly, AAIs had no significant positive effects on social interaction (-0.22, -0.51 to 0.06), social skills (-0.32, -0.87 to 0.24), problematic behaviours (-0.10, -0.54 to 0.35) or emotional problems, including depression and anxiety (-0.13, -0.51 to 0.24). As an ADHD management strategy complementary to gold-standard approaches, such as medication or multimodal interventions, AAIs did not appear to be more effective in improving the majority of core ADHD outcomes in children. Future studies should incorporate rigorous study designs with large sample sizes and a standard protocol to achieve more valid and reliable conclusion.

Association of Palliative Care Timing with End-of-Life Quality in Children with Heart Disease.

Children with heart disease are at risk for early mortality and parents often perceive suffering at end-of-life (EOL). Involvement of pediatric palliative care (PPC) is a proposed quality measure at the EOL in children with cancer, and early PPC involvement is associated with other quality measures. The impact of early PPC involvement on EOL quality is unknown in children with heart disease. Evaluate the association of early PPC on potential EOL quality indicators for children with heart disease. Children (0-21 years) treated in a cardiac ICU and who died between January 2014 to December 2022 were identified. Details about EOL, including location and mode of death, and EOL quality indicators were extracted manually from the electronic medical record. We compared demographics, EOL characteristics, and EOL quality indicators by receipt and timing of PPC (i.e. ≥30 days from (early) or <30 days of death (late). Of 140 children, 75 (54%) received early PPC and 65 (46%) received late PPC. EOL quality indicators did not vary significantly between groups, with the exception of children with early PPC were less likely to have been intubated in the last 14 days of life compared to those with late PPC (40% vs 63%, p=0.006). Our findings may indicate that quality indicators extrapolated from pediatric oncology do not apply to children with heart disease, as they have notably different disease trajectories and intervention options. We recommend defining high-quality EOL care indicators for children with heart disease as a priority.

EFFECTS OF THERAPEUTIC TAPING ON CLINICAL SYMPTOMS OF STUDENTS WITH PRIMARY DYSMENORRHEA.

Primary Dysmenorrhea (PD) is a prevalent gynaecological condition affecting young females, characterized by cyclic, cramping pelvic pain with no organic pathology. It can significantly impact their Quality of life (QOL) and academic performance. The study aimed to determine the effect of therapeutic taping on clinical symptoms, QOL and academic performance of students with PD. It was a single-blind, parallel design, Randomized controlled trial SETTING: Study conducted from May to September 2023 in Girls Hostel, Islamabad, Pakistan. Women aged 18-25 years with PD and pain severity of VAS ≥4 were recruited. Those with other health conditions and having an allergy to Kinesio taping (KT) were excluded from the study. A total of 66 women have completed the study. They were randomly assigned to three groups: experimental (KT), sham tape (ST), and control group (CG). KT tape was applied to the suprapubic and sacral regions using the ligament technique in the KT group and without stretch in the ST group. Assessments were taken at baseline, 8th and 12th weeks. The study tools were the visual analogue scale (VAS), menstrual symptoms questionnaire (MSQ), Health-related quality of life (SF-36) and Academic Performance Questionnaire (APQ). Data analysis was done using SPSS-25. The participants' mean age (years) was (KT: 22.04±2.13, Sham: 22.35±3.11 and CT: 23±2.52). Between-group analysis shows a statistically significant difference in VAS (p<0.05) and MSQ (p<0.01) after the 12th week of intervention, whereas the APQ score was statistically significant (p <0.01) on the 8th and 12th week. Similarly, the SF-36 score was significant for both physical (p<0.001) and mental (p<0.05) component summary between the intervention groups. Kinesio Taping is an effective intervention option for pain reduction, menstrual symptom relief, and improved academic performance for individuals with PD.

Neurosurgical Intervention in Primary Intraventricular Hemorrhage : Experience from a Center in China.

Primary intraventricular hemorrhage (PIVH) is a rare type of neurologic disorder and remains a challenge for cerebrovascular surgeons. This study intended to investigate the factors associated with neurosurgical intervention and its impact on outcome after PIVH. We retrospectively included consecutive patients with PIVH admitted to at a single tertiary academic medical center in China. Conservative treatment or neurosurgical intervention options (including endovascular therapy, craniotomy, stereotactic radiotherapy, endoscopic surgery or external ventricular drain) were assessed. Multivariable logistic regression was applied to determine associations. In total, 174 patients with PIVH were included in our analysis. There were 79 (45.4%) patients underwent surgery, which was associated with younger age (P = 0.004), higher Baseline Graeb score (P = 0.001), acute hydrocephalus (P = 0.02) and underlying cerebrovascular diseases (P < 0.001) in an adjusted model. In multivariable logistic regression analysis, significant predictors of external ventricular drain after PIVH were higher Baseline Graeb score (P = 0.04), and acute hydrocephalus (P< 0.001). Furthermore, after adjustment for confounders, our analysis showed that neurosurgical intervention could decrease 90-day mortality after PIVH (P = 0.04). After PIVH, younger patients with higher Baseline Graeb score, acute hydrocephalus and underlying cerebrovascular diseases were more likely to undergo neurosurgical intervention. Surgical treatment of PVIH patients should be optimized to decrease mortality. However, further clinical trials are still needed to determine which patients would benefit from neurosurgical intervention.

Evaluating an urgent care antibiotic stewardship intervention: a multi-network collaborative effort.

Urgent care centers (UCCs) have reported high rates of antibiotic prescribing for acute respiratory tract infections. Prior UCC studies have generally been limited to single networks. Broadly generalizable stewardship efforts targeting common diagnoses are needed. This study examines the effectiveness of an antibiotic stewardship intervention in reducing inappropriate prescribing for bronchitis and viral upper respiratory tract infections (URTIs) in UCCs. A quality improvement study comparing inappropriate antibiotic prescribing rates in UCCs after the introduction of an antibiotic stewardship intervention. Forty-nine UCCs in 27 different networks from 18 states, including 1 telemedicine site. Urgent care clinicians from a national collaborative of UCCs, all members of the Urgent Care Association. The intervention included signing a commitment statement and selecting from 5 different intervention options during 3 plan-do-study-act cycles. The primary outcome was the percentage of urgent care encounters for viral URTIs or bronchitis with inappropriate prescribing, stratified by clinician engagement and diagnosis. A 3-month baseline and 9-month intervention period were compared using a regression model using a generalized estimating equation. Among 15,385 encounters, the intervention was associated with decreases in inappropriate antibiotic prescribing for bronchitis (48% relative decrease, aOR = 0.52; 95% CI, 0.33-0.83) and viral URTIs (33%, aOR = 0.67; 95% CI, 0.55-0.82) among actively engaged clinicians compared to baseline. The intervention did not result in significant changes for clinicians not actively engaged. This intervention was associated with reductions in inappropriate prescribing among actively engaged clinicians. Implementing stewardship interventions in UCCs may reduce inappropriate antibiotic prescriptions for common diagnoses; however, active clinician engagement may be necessary.

Minimally Invasive Versus Open Spinal Fusion Surgery for Spondylolisthesis Treatment.

In recent years, there has been a growing utilization of minimally invasive (MI) techniques, which provide the potential advantages of minimizing surgical stress, post-operative pain, and hospitalization duration. Nevertheless, the existing body of literature primarily comprises of studies conducted at a single medical site, which are of low quality and lack a comprehensive analysis of treatment techniques exclusively focused on spondylolisthesis. We conducted this systematic review and meta-analysis to compare minimally invasive surgery (MIS) and open surgery (OS) spinal fusion outcomes for the treatment of spondylolisthesis. OS spinal fusion is an interventional option for patients with spinal illness who have not had success with non-surgical treatments. This systematic review of the literature regarding MI and OS spinal fusion for spondylolisthesis treatment was performed using the preferred reporting items for systematic reviews and meta-analysis guidelines for article identification, screening, eligibility, and inclusion. Electronic literature search of Medline/PubMed, Cochrane Library, and Google Scholar databases yielded 1078 articles. These articles were screened against established criteria for inclusion into this study. A total of eight retrospective and four prospective articles with a total of 3354 patients were found. Reported spondylolisthesis grades were I and II only. Overall, MI was associated with lower operative time (mean difference [MD], -6.44 min; 95% confidence interval [CI], -45.57-32.71; P = 0.0001) and shorter length of hospital stay (MD, -0.49 days; 95% CI, -0.58 to -0.40; P = 0.000). There was no significant difference overall between MIS and OS in terms of functional or pain outcomes. Rates of complications were not significantly different between the MI group and the OS group, though overall 75 and 153 complications were observed in MI group and OS group. Available data indicate that MI spinal fusion is a secure and efficient method for managing Grade I and Grade II spondylolisthesis. Furthermore, whereas prospective trials establish a connection between MI and improved functional outcomes, it is necessary to conduct longer-term and randomized trials to confirm any correlation identified in this study.

Supporting General Practitioners and people with hypertension to maximise medication use to control blood pressure: the contribution of Collective Intelligence to the development of the ‘Maximising Adherence, Minimising Inertia’ (MIAMI) intervention

ABSTRACT Background: Hypertension remains one of the most important modifiable risk factors for stroke and heart disease. Anti-hypertensive medications are effective, but are often not used to maximum benefit. Sub-optimal dosing by prescribers and challenges with medication-taking for patients remain barriers to effective blood pressure control. Objectives: We aimed to systematically develop a theory-based complex intervention to support General Practitioners (GPs) and people with hypertension to maximise medication use to control blood pressure. Methods: We used the three-phase Behaviour Change Wheel (BCW) as the overarching intervention development framework. Collective Intelligence methodology was used to operationalise the stakeholder input to Phases 2 and 3 of the BCW. This took the form of a Collective Intelligence workshop with 19 stakeholders from diverse backgrounds including lived experience, general practice, nursing, pharmacy and health psychology. Techniques such as barrier identification, idea-writing and scenario-based design were used to generate possible intervention options. Intervention options were then selected and refined using the Acceptability, Practicability, Effectiveness, Affordability, Side-effects and Equity (APEASE) criteria and guidance from the MIAMI Public and Patient Involvement Panel. Results: The finalised MIAMI intervention consists of both GP and patient supports. GP supports include a 30-minute online training, information booklet and consultation guide (drop-down menu) embedded within the patient electronic health system. Patient supports include a pre-consultation plan, website, and a structured GP consultation with results from an Ambulatory Blood Pressure Monitor and urine chemical adherence test. The intervention components have been mapped to the intervention functions of the BCW and Behaviour Change Technique Ontology. Conclusion: Collective Intelligence offered a novel method to operationalise stakeholder input to Phases 2 and 3 of the BCW. The MIAMI intervention is now at pilot evaluation stage.

Contemporary Management of the Aortic Valve-Narrative Review of an Evolving Landscape.

Background: Aortic valve replacement has undergone novel changes in recent decades, providing not only a multitude of procedural options but expanding the treatable patient population. Specifically, a number of minimally invasive and interventional treatment options have allowed for the treatment of high and prohibitive risk surgical patients. Further, technology is allowing for the development of innovative surgical and transcatheter valve models, which will advance the treatment of aortic valve disease in the future. Objective: Here, we choose to describe the modern aortic valve replacement techniques and the available valves and designs.

Just-in-Time Adaptive Interventions for Depression

Mental problems are disorders whose incidence is increasing with the effect of the global crises experienced in the world today and which significantly reduce the functionality of the individual. Depression draws attention as the most common mental problem. An average of two-thirds of individuals diagnosed with depression cannot receive treatment due to treatment cost, transportation, stigma, lack of information, low perceived need for treatment, and barriers to seeking mental health help.Internet-based interventions can offer highly effective and advantageous suggestions to overcome the disadvantages created by these barriers. As an internet-based intervention, Just-in-Time Adaptive Interventions (JITAIs) is an intervention design that aims to provide the right type and intensity of support at the right time by adapting to the changing internal and contextual situation of the individual. This intervention has emerged from the need to use mobile health in general, to address situations of vulnerability for adverse health outcomes, and to take advantage of rapid, unexpected, ecologically emerging situations of opportunity. In general, the mechanisms of JITAIs include 6 key elements: vulnerability/opportunity situation, distal outcome, proximal outcomes, decision points, intervention options, adaptation of variables and decision rules. Considering the potential rise of depression, especially in relation to new global events (e.g., pandemics and economic downturns), this application, which can be considered as a scalable, fully automated self-administered biopsychosocial transdiagnostic digital intervention, can provide widespread benefits. In this study, we focus on the working principles and advantages of JITAIs in general.

The Effect of Nutritional Intervention in Nutritional Risk Screening on Hospitalised Lung Cancer Patients

Background: Lung cancer (LC) patients are prone to suffer from malnutrition. Malnutrition negatively affects patients’ response to therapy, increases the incidence of treatment-related side effects, and decreases survival. Early identification of LC patients who are malnourished or at risk of malnutrition can promote recovery and improve prognosis. Objective: This study aimed to assess the risk and nutritional status of lung cancer patients who are hospitalised, as well as to evaluate the impact of nutritional intervention on the risk of malnutrition. Methods: From January 2022 to December 2023, 53 LC patients hospitalised in a pulmonology department had their nutritional risk (initial and final) and nutritional status (initial) assessed. All were selected for nutritional intervention. Nutrition counselling was the first intervention option, along with dietary changes with/without oral nutritional supplements. Results: At the time of hospitalisation, 90.6% of the patients were at nutritional risk, 45.3% were classified as moderately malnourished, and 35.8% were classified as severely underweight. After the hospitalisation, 73.6% were at nutritional risk at the time of discharge, suggesting a statistically significant decrease in the number of patients with nutritional risk. Conclusions: Most LC patients hospitalised presented an altered nutritional status. Our study suggests that a nutritional intervention must be implemented to reduce malnutrition risk, which may impact prognosis. The comprehensive nutritional problems experienced by LC patients require nutritional assessment and improved individually tailored nutritional support.

The 595-nm Wavelength Pulsed Dye Laser for Pediatric Port-Wine Birthmarks and Infantile Hemangiomas: A Systematic Review.

The 595-nm wavelength pulsed dye laser (PDL) is well-established in the treatment of vascular lesions. In June 2023, it received FDA clearance for the treatment of port-wine birthmarks (PWB) and infantile hemangiomas (IH) in the pediatric population. Review the evidence regarding the efficacy, safety, and implications of using PDL for management of pediatric PWB and IH. A systematic literature search was performed to identify peer-reviewed articles and clinical trials published between July 2002 and December 2022 in which PDL was used to treat pediatric PWB and IH. After application of criteria, 33 journal articles with 7725 total patients were included. Only 16 (0.8%) of the 2,033 patients with PWB and 11 (0.2%) of the 5692 patients with hemangioma reported permanent adverse effects including scarring, keloids, or permanent pigmentation change, and none reported blindness or other serious injury. Good, excellent, or complete clearance after PDL-on average or in greater than 50% of patients-was reported in 17 of 19 studies (89%) that reported these measures for PWB, and seven of the seven studies (100%) for IH. The 595-nm PDL is an excellent treatment option for early intervention in pediatric patients with PWB or IH.

&lt;sub&gt;&lt;/sub&gt;Carbon footprints and CO&lt;sub&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/sub&gt; removal in primary production of coffee: a meta-analytical review

Producing countries and value-chain participants are seeking to minimize the effect of coffee production on global warming. In support of this goal, we present a global review of carbon footprints and atmospheric-CO&lt;sub&gt;2&lt;/sub&gt; removal rates in primary production of coffee, based on 21 studies of carbon footprint and 16 with data on CO&lt;sub&gt;2&lt;/sub&gt; removal rate. We aimed to characterize typical values, identify determinants, compare arabica and robusta coffee, compare cropping systems, and suggest ways of reducing footprints and increasing CO&lt;sub&gt;2&lt;/sub&gt; removal rates. The median ± interquartile range of carbon footprints of coffee production were 2954 ± 3636 CO&lt;sub&gt;2&lt;/sub&gt;e ha&lt;sup&gt;-1&lt;/sup&gt; yr&lt;sup&gt;-1&lt;/sup&gt; (area carbon footprint, ACF) and 2.18 ± 2.04 CO&lt;sub&gt;2&lt;/sub&gt;e kg&lt;sup&gt;-1&lt;/sup&gt; green beans (product carbon footprint, PCF). Manufacture and application of fertilizers, particularly nitrogenous fertilizers, were almost always the main emissions sources (65–100% of the total). ACF was significantly higher in arabica than robusta, while ACFs of agroforestry and organic systems were &lt;50% of those of unshaded and non-organic systems; these differences were also significant. PCF of organic production was significantly lower than that of non-organic production, but marginally so; no other significant differences in PCF were found. The median CO&lt;sub&gt;2&lt;/sub&gt; removal rate of unshaded production was 6990 ± 3405 kg CO&lt;sub&gt;2&lt;/sub&gt; ha&lt;sup&gt;-1&lt;/sup&gt; yr&lt;sup&gt;-1&lt;/sup&gt;. For agroforestry production the median was much higher (17 676 ± 3971 kg CO&lt;sub&gt;2&lt;/sub&gt; ha-1 yr&lt;sup&gt;-1&lt;/sup&gt;). Removal rates of organic and non-organic production did not differ significantly. We present a generalized approach for reducing the overall global-warming effect of coffee production, consisting of 10 options for interventions within an overarching principle of zero deforestation. Wider use of agroforestry production and use of organic nitrogen sources are central to the interventions. Implementation of interventions will also require the building of enabling frameworks that allow farmers to meet climate-change mitigation goals without sacrificing productivity or profitability.

A-I-D for cascades: an application of the Behaviour Change Wheel to design a theory-based intervention for addressing prescribing cascades in primary care

BackgroundPrescribing cascades, which occur when a medication is used to treat the side effect of another medication, are important contributors to polypharmacy. There is an absence of studies that evaluate interventions to address them. We describe an application of the Behaviour Change Wheel (BCW) to design theory-informed interventions for addressing prescribing cascades within interprofessional primary care teams.MethodsThe BCW framework was applied to guide intervention development. This report describes the first seven steps. Three behaviours were developed based on data collected from two qualitative studies exploring why and how cascades occur across practice settings. A target behaviour was selected and the COM-B model was applied to identify relevant factors for interprofessional primary care teams. Relevant intervention types, policy options, and corresponding behaviour change techniques (BCTs) were identified, and intervention examples drafted. Prioritization of behaviours and intervention examples were guided by the APEASE criteria.ResultsThe three behaviours involved supporting: (1) healthcare providers (HCPs) to ask about, investigate and manage cascades, (2) the public to ask about prescribing cascades, and (3) the public to share medication histories and experiences with HCPs. The team selected the HCP behaviour, A-I-D (ask, investigate, deprescribe), for intervention development. Psychological capability and physical opportunity were the most relevant COM-B components. Ten intervention options comprised of BCTs were developed, which are ready for further prioritization by stakeholders. These can be grouped into: provision of educational materials for use by HCPs; provision of consultation or training to support HCPs; and knowledge mobilization strategies. Through the process, the team identified that development of a practice guidance tool, which assists HCPs to investigate and manage prescribing cascades, is needed to support further intervention development.ConclusionsThe BCW framework guided the design of intervention examples to support primary HCPs practicing in interprofessional teams to address prescribing cascades. When identifying interventions for future consultation, creation of a practice guidance tool was prioritized as it underpins all proposed interventions for addressing prescribing cascades in practice. Further research is needed to determine what primary HCPs would need in this practice guidance tool and how it will be used in practice, to support its development.

Comparative analysis of cognitive behavioral therapy and dialectical behavior therapy in enhancing psychological capital among medical students: a randomized controlled trial.

Medical students are confronted with a complex stress environment, encompassing academic challenges, residency training, and future workplace pressures. Therefore, the exploration of effective psychological capital intervention strategies is crucial for enhancing their mental health and promoting career development. The aim of this study was to evaluate the efficacy of group cognitive-behavioral therapy (GCBT) and dialectical behavior therapy (DBT) in boosting the psychological capital of medical students and to compare the advantages and disadvantages of these two therapies. A randomized controlled trial was conducted, recruiting 56 second-year medical students, who were randomly assigned into three groups: GCBT intervention group, DBT intervention group, and control group. The intervention period lasted for 6 weeks, during which the GCBT and DBT groups received respective interventions, while the control group did not receive any intervention. Regardless of whether GCBT or DBT was used as an intervention, the psychological capital levels of the intervention group students showed significant improvement (mean ± SD, p < 0.05), with effect sizes ranging from 0.324 to 0.667. Further follow-up studies revealed that this improvement remained stable within 1 month post-intervention (mean ± SD, p < 0.05). Both group cognitive-behavioral therapy (GCBT) and dialectical behavior therapy (DBT) have been proven to be effective psychological intervention methods, capable of significantly enhancing the psychological capital of medical students. However, there are certain differences in their effects, providing diverse intervention options to cater to the varied psychological needs of medical students.

Therapeutic Potential of Silicon Supplementation in Age-Related Diseases: A Comprehensive Review

Silicon, the second most abundant element in nature, plays a crucial role in human health. Despite its understated presence, silicon's multifaceted contributions to various physiological processes make it a promising option for therapeutic intervention. Through a comprehensive analysis of recent scientific literature, this review explores the impact of silicon supplementation on bone health, cardiovascular function, metabolic regulation, and neuroprotection. Review methods involved the analysis of scientific publications found in databases such as PubMed and scientific journals, including meta-analyses, randomized trials, and systematic reviews, concerning the scope of medical and nutritional problems, excluding case reports. Key findings suggest that silicon supplementation may positively influence bone mineral density, bone regeneration, and collagen synthesis, offering potential benefits for individuals at risk of osteoporosis and musculoskeletal disorders. Furthermore, evidence highlights silicon's role in regulating cardiovascular health, indicating its potential to mitigate atherosclerosis risk and improve lipid profiles, thereby offering promise in managing conditions such as diabetes and dyslipidemia. Additionally, emerging research underscores silicon's neuroprotective properties, hinting at its potential in combating neurodegenerative diseases like Alzheimer's. This review emphasizes the promising prospect of silicon supplementation as a complementary strategy for enhancing overall health and addressing age-related diseases.

The Relationship Between Insight and Anxiety Within a Diverse Alzheimer’s Disease Sample

AbstractBackgroundA growing number of individuals and families are affected by Alzheimer’s disease (AD) across the United States. Changes in insight and levels of anxiety have been extensively but independently investigated in this population. In contrast, research on the relationship between insight and anxiety has been limited and has yielded inconsistent results.MethodThe present study used the NACC Uniform Dataset (N = 18,671) to examine cross‐sectional associations between insight and anxiety in a diverse AD sample in order to better understand their potential role in individuals’ presenting symptoms and overall distress.ResultResults showed that although higher insight was associated with higher anxiety, this effect disappeared when controlling for other variables. Instead, age of onset, disease severity, and depression severity emerged as significant predictors of greater anxiety. In addition, depressive symptoms also moderated the relationship between insight and anxiety. For participants with lower depression, high insight was associated with lower anxiety. Results also supported the notion that race/ethnicity may play a role in the relationship between insight and anxiety. Overall, Black/African American participants in this study had somewhat lower levels of anxiety than other participants. In addition, within participants with low insight only, Hispanic/Latino/a/x participants had higher levels of anxiety than others.ConclusionThese findings provide valuable insight into the emotional experiences of patients with AD and may help inform clinicians about potential treatment and intervention options.

Modern-Day Management of the Dysglycemic Continuum: An Expert Viewpoint from the Arabian Gulf.

Prediabetes is the first stage of a continuum that extends through the diagnosis of clinical type 2 diabetes towards long-standing diabetes with multiple comorbidities. The diagnosis of prediabetes provides an opportunity to interrupt the diabetes continuum at an early stage to ensure long-term optimization of clinical outcomes. All people with prediabetes should receive intervention to improve their lifestyles (quality of diet and level of physical activity), as this has been proven beyond doubt to reduce substantially the risk of conversion to diabetes. Additionally, a large base of clinical evidence supports the use of metformin in preventing or delaying the transition from prediabetes to clinical type 2 diabetes, for some people with prediabetes. For many years, guidelines for the management of type 2 diabetes focused on lowering blood glucose, with metformin prescribed first for those without contraindications. More recently, guidelines have shifted towards prevention of diabetes complications as the primary goal, with increased use of GLP-1 receptor agonists (or multi-agonist incretin peptides) or SGLT-2 inhibitors for patients with existing atherosclerotic cardiovascular disease, heart failure or chronic kidney disease. Access to these medications often remains challenging. Metformin remains a suitable option for initial pharmacologic intervention to manage glycemia for many people with prediabetes or type 2 diabetes along with other therapy to maintain control of blood glucose or to address specific comorbidities as the patient progresses along the diabetes continuum.

Downregulated DKK2 may serve as a molecular mechanism of high-fat diet-induced myocardial injury via Wnt/β-catenin pathway.

High-fat diet could induce structural and functional disorders of the heart, but the underlying mechanism remains elusive. This study aimed to explore related mechanism of obesity cardiomyopathy. Obesity model was established by feeding rats with a high-fat diet, and H9c2 cells were stimulated with palmitic acid to mimic high-fat stimulation. Whole transcriptome analysis results showed that the expression of Dickkopf-2 (DKK2) in obesity cardiomyopathy group was significantly lower than that in control group and simple obesity group. Overexpression and knockdown of DKK2 was achieved by infection with lentivirus. Weight, blood glucose, lipids, blood pressure, and insulin, HE staining, Sirius red staining and echocardiography results were analyzed in rats at 8 and 16weeks after various interventions. qRT-PCR and western blots were used to detect the expression of RNAs and proteins. High-fat diet-induced obese rats presented with changes in serum lipid, insulin, and increases in myocardial inflammation and fibrosis. Protein and mRNA expression levels of DKK2 were significantly decreased in the obesity cardiomyopathy group compared with the obesity and control group. In vitro, knockdown of DKK2 activated β-catenin/Wnt3a pathway, while overexpress of DKK2 inhibited β-catenin/Wnt3a expression. Activating DKK2 may serve as a novel therapeutic intervention option for obesity cardiomyopathy and obesity-related metabolic disorders, and future studies are needed to validate this hypothesis.

The potential of noninvasive brain stimulation techniques for the treatment of central nervous system demyelinating diseases: a narrative review

Noninvasive brain stimulation techniques have emerged as a promising therapeutic option for various central nervous system demyelinating diseases. Demyelinating diseases represent a group of pathological conditions that impact the central or peripheral nervous system. They are characterized by damage to or loss of the myelin sheath surrounding nerve fibers. This damage to myelin sheaths disrupts nerve signal transmission, leading to a wide range of signs and symptoms associated with neurological impairment. Treatment for demyelinating diseases usually aligns with the specific underlying cause. Noninvasive brain stimulation techniques can affect neuronal electrical activity and glial cell function, suggesting a potential option for intervention. In this narrative review, we explore the potential of noninvasive brain stimulation techniques for the treatment of central nervous system demyelinating disorders. Noninvasive brain stimulation techniques, including transcranial magnetic stimulation, transcranial electrical stimulation, transcranial focused ultrasound stimulation, optogenetic stimulation, low-intensity pulsed ultrasound, and transcranial photobiomodulation, have been shown to potentially intervene in the treatment of demyelinating diseases by affecting the electrical activity of nerve cells and glial cell function. In addition, this review summarizes the applications and mechanisms of noninvasive brain stimulation techniques in the treatment of central nervous system demyelinating diseases and how these techniques promote myelin regeneration and improve disease prognosis. This review also summarizes research advances in noninvasive brain stimulation techniques for the treatment of multiple sclerosis, acute disseminated encephalomyelitis, progressive multifocal leukoencephalopathy, and neuromyelitis optical spectrum disorder. Noninvasive brain stimulation techniques can improve disease symptoms by promoting oligodendrocyte proliferation and differentiation, enhancing myelin regeneration, and modulating immune responses. Although noninvasive brain stimulation techniques have shown potential in the treatment of various neurological disorders, their use in treating demyelinating diseases remains challenging. For example, transcranial focused ultrasound stimulation is a relatively new noninvasive brain stimulation technique with the advantages of high spatial resolution and the ability to stimulate deep brain structures, but its safety and efficacy in clinical applications need to be further investigated. Optogenetic stimulation offers highly precise neuromodulation, but its feasibility in clinical practice is limited by technical and ethical constraints. Overall, noninvasive brain stimulation techniques have significant potential in the treatment of central nervous system demyelinating diseases, but further research is needed to optimize stimulation parameters, improve therapeutic efficacy, and gain insight into their mechanism of action. With the continuous development of technology and in-depth clinical trials, noninvasive brain stimulation techniques are expected to become an effective treatment for central nervous system demyelinating diseases and provide new therapeutic options for such patients.