Group Level Research Articles

The Impact of Lymphatic Drainage and Nerve Mobilization Techniques on Nerve Morphology in Mild-to-Moderate Carpal Tunnel Syndrome: A Randomized Controlled Trial.

To investigate whether nerve mobilization related to nerve mobility or the removal of edema using lymphatic drainage affects the cross-sectional area of the nerve, hand function, and symptom severity in carpal tunnel syndrome. The study is a prospective randomized controlled trial. Data were analyzed between groups using ANOVA, Chi-squared test, and Kruskal-Wallis test. Treatment lasted 4 weeks. Splint group wore the splint daily. Splint+manual lymphatic drainage received lymphatic drainage 5 days a week. Splint+nerve mobilization performed neuromobilization exercises as home exercises 5 days a week. Evaluations were conducted before and after 4 weeks of treatment. The study included 80 patients with mild-to-moderate carpal tunnel syndrome. The patients were randomly divided into three groups: splint (n = 27), splint+manual lymphatic drainage (n = 27), or the splint+nerve mobilization (n = 26). The main outcome measures were ultrasound assessments and the Boston Carpal Tunnel Questionnaire (Symptom Severity Scale and Boston Functional Status Scale). Compared to the other groups, the nerve cross-sectional area decreased at both the carpal tunnel (p = 0.003) and mid-forearm (p = 0.014) levels in the drainage group. Nerve mobilization did not result in a significant change in the nerve cross-sectional area. All groups showed significant improvements in both symptom severity and functional status scores (p < 0.001). The reduction of edema through lymphatic drainage contributes to a decrease in the cross-sectional area of the median nerve. Additionally, all three methods appear to positively impact the functional capacity of the hand and alleviate symptoms.

Exploration of physical activity, sedentary behavior and insulin level among short sleepers.

Sufficient physical activity and sleep duration are essential for overall health. While one-third of the US population reports short sleep (<7 h), which is proven to link with negative health status. Current evidence on the relationship between physical activity, sedentary behavior, and serum insulin level in short sleep groups is limited. The National Health and Nutrition Examination Survey (NHANES) was used to conduct this cross-sectional study of 8,494 adults (NHANES) 2007-2018. Serum insulin was quantitatively tested by human insulin immunoassay. Short sleep conditions were defined as ≤7 h per night. Physical activity conditions, including work activity, recreational activity, and sedentary behavior, were self-reported in NHANES by the Physical Activity Questionnaire using a 7-day recall method. The main analyses utilized weighted linear regression models due to the complex multistage sampling design of NHANES. Subgroup analysis and the influence of different lipid indices were explored in this study. In addition, a sensitivity analysis of participants without diabetes was conducted. In fully adjusted models, increased levels of work and recreational activity significantly reduced insulin levels, with β values 95% CI = -0.002 (-0.003, 0.001) and β values 95% CI = -0.008 (-0.012, -0.003), respectively. However, sedentary behavior was positively associated with insulin levels, with a β value 95% CI =0.022 (0.009, 0.034). The sensitivity analysis further confirmed the benefits of recreational activity in controlling insulin levels. Through sex stratification analysis, it seemed that physical activity was more obviously impacted in the male than female groups. Overall, our analysis demonstrates that in short sleepers, an increased level of work and recreational activity is beneficial to control the insulin level, and more sedentary time is harmful. However, this association might be discrepant in different sexes and different levels of lipid indices.

Effects of vitamin D supplementation on serum 25(OH)D3 levels and neurobehavioral development in premature infants after birth

This study explored the factors influencing serum 25(OH)D3 levels and the effects of Vitamin D deficiency (VDD) and VD supplementation on 25(OH)D3 levels and neuropsychobehavioral development in premature infants, to provide a theoretical basis for improving their prognosis. Physical examination, neuropsychobehavioral development and serum 25(OH)D3 levels were assessed regularly in 158 preterm infants supplemented with VD formulation. 25(OH)D3 levels were analyzed at 3, 6, 9, 12, and 18 months after birth. The Gesell neuropsychological development test was conducted at 6, 9, 12, and 18 months after birth to obtain the developmental quotient (DQ). Based on the serum 25(OH)D3 levels at 42 days of age, the infants were divided into VDD and non-VDD groups. Preterm infants in the VDD group were supplemented with more VD until their 25(OH)D3 levels were normal, and were divided into sustained VDD (SVDD) and corrected VDD (CVDD) groups according to serum 25(OH)D3 levels at 3 months of age. Appropriate statistical methods were chosen to compare differences in 25(OH)D3 and DQ between or among different groups, screen for the factors influencing 25(OH)D3 levels in preterm infants at 42 days of age, and analyze the relationship between 25(OH)D3 and DQ. The 25(OH)D3 levels of preterm infants at 42 days of age were positively correlated with VD supplementation during pregnancy, and before 42 days after birth (P < 0.05). The 25(OH)D3 levels in preterm infants at 42 days and 3 months of age were positively correlated with the DQ levels at 6, 9, 12, and 18 months of age (P < 0.05). The DQ level in the VDD group, especially SVDD group, was lower than that in CVDD and non-VDD groups at the same time point (P < 0.05). This research thus demonstrates that VD supplementations during pregnancy and after birth is a major factor affecting 25(OH)D3 levels in premature infants. Early VDD and SVDD can affect their neuropsychobehavioral development, and effective VD supplementation can gradually correct VDD and mitigate this influence.

Equitable stormwater utility fees: an integrated analysis of environmental, socioeconomic and infrastructure factors at the community scale

Abstract Municipalities worldwide implement stormwater management programs to mitigate the hydrological and water quality impacts of stormwater runoff. Stormwater utility fees (SWUF) are often used to fund such important programs by collecting revenue from residential and commercial properties. However, existing SWUFs often solely rely on the estimate of impervious surfaces and do not consider other environmental, infrastructure, and socioeconomic factors in the generation and effects of stormwater runoff. This study is the first attempt to propose a reconstruction of SWUFs from the perspectives of social equity and environmental justice. The method aims to address disparities in fee rates among residential parcels, focusing on helping economically disadvantaged communities. It integrates drainage service, potential contribution to non-point source pollution, and socioeconomic status through two alternative schemes. The two schemes allocate fees based on combined rankings of the three factors at the level of census block groups. The proposed method was applied to 88 180 residential parcels in Corpus Christi, Texas, a mid-sized coastal community. The results suggest that over 70% of the disadvantaged communities would benefit from the reconstructed SWUFs without affecting the targeted funding for stormwater infrastructure. This method builds on publicly available datasets and offers an adaptive framework for other municipalities to incorporate additional factors or datasets, representing an exploratory step toward achieving more equitable stormwater management practices.

Clinical characteristics and factors associated with mucus plugs under bronchoscopy in children hospitalized for acute asthma attack.

To describe clinical characteristics of hospitalized children with acute asthma attacks complicated with mucus plugs and to investigate the factors associated with mucus plugs in asthma children. This retrospective study analyzed hospitalized children and adolescents with acute asthma attacks from January 2016 to December 2021. The demographic information and characteristics were collected. Subjects were categorized into the mucus plug group and the control group based on the bronchoalveolar lavage results. The Logistic regression analyses were utilized to assess the relative factors associated with mucus plugs. All data were analyzed using SPSS 22.0. This study included 242 individuals. Out of the 151 subjects who underwent bronchoscopy, 62.9% were classified in the mucus plug group and 37.1% in the control group. The subjects with dyspnea had a higher proportion in the mucus plug group (52.6% vs. 26.8%). The serum total IgE level of the mucus plug group was lower than the control group. The proportion of subjects who were diagnosed with asthma for the first time during hospitalization (87.4% vs. 76.8%) and combined with respiratory infection (91.6% vs. 82.1%) in the mucus plug group might be higher than that in the control group. More subjects in the mucus plug group were administered systemic glucocorticoid, magnesium sulfate, aminophylline, and mucolytic drugs after hospitalization. In multivariable analysis, diagnosed with asthma for the first time during hospitalization (OR = 4.404; 1.101-17.614), dyspnea (OR = 4.039; 1.306-12.496), and cesarean (OR = 0.274; 0.092-0.812) might be associated with mucus plug in children hospitalized for an acute asthma attack. While our retrospective study suggests that some clinical features of children hospitalized with asthma who have mucus plugs differ from those without, further studies are required.

Socioeconomic Factors and Physical Activity Levels Among Badminton Players in Selected Middle Schools in Guangdong Province

The relationship between socioeconomic factors and physical activity levels in badminton player is a critical area of study, given the long-term implications for health and well-being. Various socioeconomic determinants, including family income, parental education, and neighborhood environment, significantly influence badminton player' engagement in physical activities (Sharma &amp; Gupta, 2021). Family income plays a pivotal role in determining the availability of resources necessary for physical activity. Badminton player from higher-income families often have access to sports equipment, private coaching, and safe recreational facilities, which promote regular physical activity (Patel et al., 2022). Conversely, those from lower-income backgrounds may face financial barriers that limit their participation in organized sports or access to quality facilities, leading to reduced physical activity levels (Rahman &amp; Khan, 2023). Parental education is another significant factor influencing badminton player' physical activity. Educated parents are more likely to recognize the importance of physical activity for their children's health and development (Basu &amp; Das, 2021). They may also have better knowledge and resources to support their children’s involvement in sports and physical activities. In contrast, lower parental education levels are often associated with less awareness and fewer opportunities for badminton player to engage in physical activity (Singh et al., 2020). The neighborhood environment significantly impacts badminton player' physical activity levels. Safe, well-maintained neighborhoods with parks, playgrounds, and sports facilities encourage outdoor activities (Hassan &amp; Rafiq, 2021). However, badminton player living in neighborhoods with high crime rates, poor infrastructure, or limited recreational spaces may be less likely to engage in physical activities due to safety concerns and lack of accessible facilities (Chowdhury et al., 2023). Cultural factors also influence physical activity levels among badminton player. In many societies, cultural norms and expectations can either promote or hinder physical activity (Kumar &amp; Jain, 2022). For instance, traditional gender roles may restrict girls’ participation in sports, while boys might be encouraged to engage in physical activities. Understanding these cultural dynamics is essential for developing effective interventions to promote physical activity among all badminton player. The impact of socioeconomic status (SES) on physical activity is further compounded by educational institutions. Schools in higher SES areas often have better sports facilities, more extracurricular activities, and programs promoting physical education (Sharma &amp; Gupta, 2021). Conversely, schools in lower SES areas may lack these resources, limiting students' opportunities to engage in regular physical activity. This disparity highlights the need for policies to ensure equitable access to physical activity opportunities across different socioeconomic strata. Peer influence is another crucial factor in badminton player' physical activity levels. Badminton player are more likely to engage in physical activities if their peers also participate (Basu &amp; Das, 2021). However, socioeconomic factors can affect the peer group's overall activity levels. Badminton player from higher SES backgrounds might have more active peer groups due to greater access to recreational activities, whereas those from lower SES backgrounds might face peer pressure to engage in sedentary behaviors. Government policies and community programs play a vital role in addressing the socioeconomic disparities in physical activity levels among badminton player. Policies that provide subsidies for sports programs, build recreational facilities in underprivileged areas, and promote safe neighborhood environments can help mitigate the impact of socioeconomic factors (Patel et al., 2022). Effective community programs that target low-income families and educate parents about the benefits of physical activity are also crucial for promoting equitable physical activity levels. Technological advancements and their accessibility also influence physical activity levels. Badminton player from higher SES backgrounds might have access to technology that encourages physical activity, such as fitness trackers and online workout programs (Kumar &amp; Jain, 2022). In contrast, those from lower SES backgrounds may lack access to such technology, further widening the gap in physical activity levels. Socioeconomic factors significantly influence physical activity levels among badminton player. Family income, parental education, neighborhood environment, cultural norms, school resources, peer influence, government policies, and technological accessibility all play crucial roles. Addressing these factors through targeted interventions and policies is essential for promoting equitable physical activity levels and ensuring the long-term health and well-being of all badminton player. Recent research highlights the importance of understanding and addressing these socioeconomic determinants to foster a more active and healthy youth population.

Assessing Heavy Metal Contamination in Commonly Used Fertilizers for Polyculture Fish Ponds and Its Implications for Human Health: A Comprehensive Investigation.

Over-fertilizing fish ponds can cause pollution, introducing heavy metals into the food chain and posing health risks. The present study investigated the incidence of heavy metals (Pb, Cu, Cd, and Cr) in commonly applied fertilizers, including nitrogen, phosphorus and potassium (NPK), triple superphosphate (TSP), and di-ammonium phosphate (DAP), and their association with heavy metals in water, sediment, and cultured fish species (Catla catla, Labeo rohita, and Cyprinus carpio) in polyculture fish ponds. The study was conducted over 4months, with four groups in triplicates: control (no fertilizer), group 1 (NPK), group 2 (TSP), and group 3 (DAP). Heavy metal analysis was carried out using atomic absorption spectrophotometry before and after fertilizer application. Significantly (p < 0.05) higher levels of heavy metals were observed in water and sediment after applying fertilizers, with the most pronounced results in group 3 (DAP) followed by group 2 (TSP). The concentration of heavy metals was significantly (p < 0.05) higher in group 3 (DAP) fertilizers compared to other groups. Compared to the control, the concentration and bioaccumulation of heavy metals were significantly (p < 0.05) higher in the fertilizer-applied groups, with notably higher levels in group 3 (DAP). Cluster analysis and the correlation matrix did not show any significant association between the heavy metals and the fertilizers, indicating a complex interplay between the biotic and abiotic factors of the system. The health index (HI) value was < 1 in fish muscles of all studied groups, indicating the fish are safe for consumption. The study recommends monitoring and regulating fertilizer use, especially DAP, to prevent heavy metal contamination, and exploring sustainable alternatives to minimize environmental and health risks.

Rosa roxburghii trattresidue: A novel feed resource for cattle indicated by the non-deleterious performance and blood metabolites.

Rosa roxburghii tratt residue (RRTR) is a regional and uncommon byproduct in Guizhou. Little information is available on whether RRTR can be used as feed for ruminants. In this study, the feasibility of using RRTR as a new feed resource for cattle was investigated by chemical composition analysis, in vitro gas production (Trial 1) and animal feeding experiments (Trial 2). In trial 1, compared to the commonly used fruit residues, RRTR had a proximate nutrient level; the in vitro gas production curve and dynamics fell within the normal range. In trial 2, 16 cattle were allocated to the control and treatment groups, with 8 replicates of 1 cattle each. Cattle in the control group were fed a basal diet without RRTR, while those in the treatment group were fed a diet containing 30% RRTR to replace 30% whole corn silage in basal diet. Feeding RRTR had little effect on the growth performance of the control and treatment cattle (P > 0.05). The feed-to-gain ratio was greater in the treatment group than in the control group throughout the trial period (P < 0.05). The plasma urea levels in the treatment group were lower (P < 0.05) than that in control group, and the levels of other plasma biochemical metabolites were not different between the two groups of cattle (P > 0.05). The in vivo rumen fermentation parameters did not differ between the control and treatment groups (P > 0.05). Our findings indicate that RRTR has a nutritional profile (crude protein, neutral detergent fiber, acid detergent fiber, and crude fiber) similar to that of commonly used fruit residues (such as apple, pineapple, and citrus residue et al.); improves plasma protein utilization efficiency; and has no negative impact on growth performance, albeit with limited effects on feed conversion; blood metabolites, and rumen fermentation parameters in cattle. Accordingly, we conclude, based on the above-mentioned result, that RRTR can serve as a novel feed alternative resource when considering the affordability and as a practical choice for low-cost diets for cattle.

Associations between methamphetamine use disorder and SLC18A1, SLC18A2, BDNF, and FAAH gene sequence variants and expression levels.

Assessing candidate gene sequence variations and expression helps to understand methamphetamine use disorder and inform potential treatments. We investigated single nucleotide polymorphisms (SNPs) and gene expression in four candidate genes: SLC18A1, SLC18A2, BDNF, and FAAH, between controls and people with methamphetamine use disorder. Fifty-nine participants (29 people with methamphetamine use disorder and 30 controls) completed a clinical interview, cognitive tasks, and provided a blood sample. SLC18A1, SLC18A2, BDNF, and FAAH SNPs were genotyped, and gene expression was assessed with real-time quantitative PCR. SLC18A1 Pro4Thr was associated with methamphetamine use disorder (OR = 6.22; p = .007). SLC18A2 variants, rs363227 and rs363387, were negatively associated with methamphetamine use severity (p = .003) and positively associated with inhibitory control performance (p = .006), respectively. BDNF Val66Met was associated with the severity of use (p = .008). SLC18A2 and FAAH mRNA levels were lower in people who use methamphetamine relative to controls (p = .021 and .010, respectively). SLC18A1 is identified for the first time to play a potential role in methamphetamine use disorder. Lower levels of blood SLC18A2 and FAAH mRNA in people with methamphetamine use disorder suggest reduced monoamine reuptake, recycling, or release, and higher anandamide levels in this clinical group, which may be potential therapeutic targets.

Effects of Alanyl-Glutamine Dipeptide Supplementation on Growth Performance, Nutrient Digestibility, Digestive Enzyme Activity, Immunity, and Antioxidant Status in Growing Laying Hens.

Alanyl-glutamine (Aln-Gln), a highly soluble and stable Glutamine-dipeptide, is known to improve the performance of poultry birds. This study aimed to investigate the effect of Aln-Gln during the rearing period on growth performance, nutrient digestibility, digestive enzyme activity, immunity, antioxidant status and relative gene expression of Hy-Line brown hens. A total of 480 healthy day-old Hy-line brown chicks with similar body weights were randomly divided into four dietary groups (8 replicates/group and 15 birds/replicate). Groups A, B, C and D were fed diets containing 0%, 0.1%, 0.2% and 0.3% Aln-Gln, respectively, for 6 weeks. The body weight (BW) and average daily gain (ADG) were higher in hens fed test diets compared with the control (p < 0.05). The feed conversion ratio (FCR) was better in test groups as compared to the control group (p < 0.05). The ADFI showed no significant difference between the groups. Dietary treatments had no effect on dry matter (DM), organic matter (OM) and crude fiber (CF) digestibility. The Aln-Gln also improved gross energy (GE) and crude protein (CP) digestibility (p < 0.05). It has also increased IgG levels in groups C and D. IgM levels were similar to the control in B, C and D. The Aln-Gln increased IL-1 in B and C, IL-2 in C and D, and IL-6 in all test groups (p < 0.05). The supplementation of Aln-Gln had no effect on serum antioxidant indices like CAT, MDA, GSH-PX, GSH, and SOD in 42-day-old growing hens. Aln-Gln supplementation had no significant effect (p > 0.05) on the activity of amylase and lipase, however, a significant improvement (p < 0.05) in the activities of trypsin and chymotrypsin was observed in the test groups. Supplemented Aln-Gln levels in the birds' diets led to an increase in the expression of genes related to growth factors (IGF-1, IGFBP-5), immune markers (IL-1, IL-2, IL-6) and antioxidant status (GSH-Px1), as compared to control group. Aln-Gln supplementation in Hy-Line brown hens during their growing period improved growth, nutrient digestibility, immunity and digestive enzymes activity. These findings suggest that Aln-Gln is a promising dietary additive for enhancing poultry performance.

Gaultheria procumbens essential oil longevity and oxidant/antioxidant status of silver catfish Rhamdia quelen experimentally infected by Aeromonas caviae

The increase in bacterial resistance in animals and the buildup of antimicrobials in animal meat pose significant nutritional and economic challenges. Given this context, this study explored the potential of Gaultheria procumbens essential oil (GPEO) as a sustainable alternative for aquaculture, focusing on its effects against Rhamdia quelen infected with Aeromonas caviae. Longevity tests revealed that R. quelen, when treated with 5 and 10 µL/L of GPEO, displayed significantly improved survival rates compared to both the untreated infected control group and those treated with ethanol. To understand the mechanisms behind the increased survival, a subsequent experiment with a 10 µL/L GPEO treatment aimed to investigate the oxidative stress pathway. This involved measuring levels of thiobarbituric acid reactive substances (TBARS) and reactive oxygen species (ROS), alongside enzyme activities for superoxide dismutase, glutathione peroxidase, and glutathione S-transferase. Our findings showed elevated TBARS and ROS levels in the non-infected control group treated with GPEO, suggesting an increase in these enzymes as a response to ROS balance. Therefore, our data indicate that the mechanism leading to enhanced longevity in R. quelen infected and treated with GPEO does not involve the oxidative stress pathway.

Complex therapy of mineral metabolism in service dogs

The high physical and functional load of service dogs causes changes not only in body systems, but also in metabolism as a whole. An integrated approach to the study of this problem and the search for a pharmacotherapeutic solution will allow us to correct biochemical changes in the body of dogs and improve the performance and quality of life of animals. The purpose of the study was to study the therapeutic effectiveness of a complex of metabolic stimulants for the correction of mineral metabolism. For the study, 16 service dogs were selected in the area of application of the general search profile, belonging to the Ministry of Internal Affairs of Russia in the Altai Territory. Blood was drawn at the beginning and end of the study to analyze red blood cell counts, hemoglobin, hematocrit, glucose, cholesterol, triglycerides, iron, magnesium, zinc, calcium, phosphorus, and chloride. According to the results of the study, it was established that a violation of homeostasis in service dogs was accompanied by changes in some indicators of red blood, as well as pathology of mineral metabolism. After a course of pharmacotherapy, an increase in red blood cells (up to 7.9±0.22*×1012 cells/l) and hemoglobin (up to 141.66±7.32 g/l) was observed in dogs. Carbohydrate metabolism in both groups was characterized by hypoglycemia (3.34±0.21–3.43±0.28 mmol/l). By the end of the study, the glucose level in the experimental group significantly increased by 31.4% relative to the animals in the control group. By the end of the study, cholesterol levels in dogs in the experimental group decreased more rapidly compared to the control group. The study of the dynamics of mineral metabolism indicators revealed a significant increase in iron levels in the experimental group of animals (up to 25.3±1.9 µmol/l), which was 22.8% higher than the control value. Changes in other indicators of mineral metabolism did not differ significantly between the groups, although dogs receiving stimulating therapy showed positive dynamics of changes in mineral metabolism indicators. The use of a complex of metabolic stimulants “Suiferrovita”, “Strolitin”, “Amber Acid” stabilized red blood counts and contributed to the development of a tendency towards the restoration of mineral metabolism.

Influences of Cr(VI) on SOD Activity, MDA, and MT Content in the Hepatopancreas and Gill of Portunus trituberculatus

The toxic effect and differences of Cr(VI) on superoxide dismutase (SOD) activity, MDA, and metallothionein (MT) content in the hepatopancreas and gill of Portunus trituberculatus were investigated during Cr(VI) enrichment (15 days) and release experiments (15 days). Results showed that the 1.50 and 0.30 mg/L test groups significantly exhibited higher SOD, MDA, and MT content in the hepatopancreas and gill compared with the control group after 15 days of enrichment (p &lt; 0.05). After 15 days of Cr release, the SOD, MDA, and MT content in the hepatopancreas and gill of both test groups recovered to the normal level of the control group (p &gt; 0.05). The gill of P. trituberculatus achieved the highest SOD activity, MDA, and MT content earlier than the hepatopancreas, but the highest values were lower. The gill showed a shorter recovery time than the hepatopancreas. We concluded that the gill of P. trituberculatus exhibited a more rapid response to, and recovery from, Cr(VI) exposure compared to the hepatopancreas, making it a more sensitive tissue for assessing Cr(VI) toxicity, though both tissues showed a capacity for recovery after the removal of the contaminant.

Predictors of treatment response trajectories to cognitive behavioral therapy for chronic fatigue syndrome: A cohort study

BackgroundThe response to cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) varies greatly between patients, but predictors of treatment success remain to be elucidated. We aimed to identify patient subgroups based on fatigue trajectory during CBT, identify pre-treatment predictors of subgroup membership, and disentangle the direction of predictor – outcome relationships over time. Methods297 individuals with CFS were enrolled in a standardized CBT program consisting of 17 sessions, with session timing variable between participants. Self-reported levels of fatigue, depressive, anxiety, and somatic symptoms, perceived stress, and positive affect were collected pre-treatment, and after 3, 10, and 15 sessions. Latent Class Growth Analysis (LCGA) was used to identify subgroups based on fatigue trajectories and baseline predictors of group membership. Cross-lagged structural equation models were used to disentangle predictor-outcome relationships. ResultsLCGA identified four fatigue trajectory subgroups, which were labelled as “no improvement” (23 %), “weak improvement” (45 %), “moderate improvement” (23 %), and “strong improvement” (9 %) classes. Higher pre-treatment levels of depressive, anxiety, and somatic symptoms, stress, and lower levels of positive affect predicted membership of the “no improvement” subgroup. Reductions in anxiety preceded reductions in fatigue, while the depressive symptoms – fatigue relationship was bidirectional. ConclusionsOn a group level, there were statistically significant reductions in fatigue after 15 sessions of CBT, with important individual differences in treatment response. Higher pre-treatment levels of anxious, depressive, and somatic symptoms and perceived stress are predictors of lack of response, with reductions in anxiety and stress preceding improvements in fatigue.

Neighborhood Socioeconomic Disadvantage and Acute Care Utilization in Washington State Medicaid: A Retrospective Cohort Study.

Neighborhood disadvantage has been associated with potentially preventable acute care utilization among Medicare beneficiaries, but this association has not been studied in a Medicaid population, which is important for informing more equitable care and policies for this population. To describe the association between Area Deprivation Index (ADI) and acute care utilization (including potentially preventable utilization) among Medicaid beneficiaries in Washington State. Retrospective cohort study of 100% Medicaid claims. Mixed effects logistic regression was applied to estimate the association between state-level ADI decile and acute care utilization, adjusting for age, sex, self-identified race and ethnicity, Charlson Comorbidity Index, primary spoken language, individual Federal Poverty Level, homelessness, and rurality. Standard errors were clustered at the Census block group level. 1.5 million unique adult Medicaid beneficiaries enrolled for at least 11months of a calendar year during the period 2017-2021. Binary measures denoting receipt of ED visits, low-acuity ED visits, hospitalizations in a calendar year. Increasing levels of neighborhood socioeconomic disadvantage (by ADI decile) were associated with greater odds of any ED visits (adjusted odds ratio (aOR) 1.07, 95% confidence interval (CI) 1.06-1.07), low-acuity ED visits (aOR 1.08, CI 1.08-1.08), and any hospitalizations (aOR 1.02, CI 1.02-1.02). Among Medicaid beneficiaries, greater neighborhood socioeconomic disadvantage was associated with increased acute care utilization, including potentially preventable utilization. These findings signal potential barriers to outpatient care access that could be amenable to future intervention by health systems and payers.

Zinc, copper, and selenium levels in vitiligo: a systematic review and meta-analysis

Vitiligo is a dermatological disease characterized by loss of melanocytes, causing non-scaly white macules on the skin. Zinc, copper, and selenium are important micronutrients that play a role in the normal functioning of the body and have been found to potentially aid in vitiligo treatment, although the relationship between their serum levels and vitiligo is not yet fully understood. This is a systematic review aimed at assessing the levels of serum zinc, copper, and selenium and their association with vitiligo. This review was performed following the Preferred Reporting Items of the systematic Review and Meta-Analysis (PRISMA) checklist and Cochrane guidelines. A comprehensive literature search was conducted on PubMed, Google Scholar and 41 studies published between 1970 and 2022 including 3353 vitiligo cases and 10,638 controls were included in the meta-analysis conducted from August 2022 till September 2023. The quality of the studies was assessed using the National Heart Lung and Blood Institute Study Quality Assessment tool, and the risk of bias was represented using the RobVis tool. The statistical analysis was performed using Review Manager (RevMan) Version 5.4. This meta-analysis indicate a significant decline in serum zinc levels (Z = 4.97; P < 0.0001; SMD = − 0.86; 95% CI − 1.19 to − 0.52) in vitiligo group with high statistical heterogeneity (Tau2 = 0.74; Chi2 = 513.95, d.f. = 26 [P < 0.00001]; I2 = 95%). Similarly for serum copper levels there was decline (Z = 2.43; P < 0.0001; SMD = − 0.50; 95% confidence interval [CI] − 0.91 to − 0.10) in vitiligo group and high statistical heterogeneity (Tau2 = 0.92; Chi2 = 475.10, d.f. = 22 [P < 0.00001]; I2 = 95%). On the other hand, there was a increase of serum selenium levels in the vitiligo group (Z = 0.56; P < 0.0001; SMD = 0.23; 95% confidence interval [CI], 0.58 to 1.04) and the results reveals high statistical heterogeneity among studies (Tau2 = 1.93; Chi2 = 406.44, d.f. = 11 [P < 0.00001]; I2 = 97%) in vitiligo patients compared to healthy controls. Publication bias was not found for the studies analysed. This study analyses the association of serum micronutrient levels and vitiligo among patients and controls from published research along with sub-group analysis specific to Asian populations using a meta-analysis. Low serum levels of Zinc and copper and high selenium levels are associated with Vitiligo.

Transient destabilization of interhemispheric functional connectivity induced by spreading depolarization

ABSTRACT Cortical spreading depolarization (CSD), a slowly propagating wave of transient cellular depolarization, is a reliable cortical response to various brain insults (stroke, trauma, seizures) and underlying mechanism of migraine aura. Little is known about CSD effects on brain network activity. Using undirected (mutual information, MI) and directed (transfer entropy, TE) measures, we studied the dynamics of cross-hemispheric connectivity associated with the development of unilateral CSD in freely behaving rats and the involvement of inhibitory transmission in mechanisms of the coupling changes. We show that the development of CSD in the cortex of one hemisphere is followed by the transient loss of undirected functional connectivity (MI) between ipsilateral and contralateral cortical regions. The post-CSD functional disconnection of the hemispheres was accompanied by an increase in driving force from an unaffected contralateral cortex to an affected one (TE). Mild cortical disinhibition produced by pretreatment with an inhibitory receptor blocking agent (penthylenetetrazole) did not affect CSD but attenuated (MI) or eliminated (TE) the CSD-induced connectivity changes. The effects of CSD on functional connectivity in awake rodents were similar at the individual and group levels, suggesting that the described connectivity response may be a promising network biomarker of CSD occurrence in patients.

Comparison of Dietary Supplementation with Krill Oil, Fish Oil, and Astaxanthin on an Experimental Ethanol-Induced Gastric Ulcer Model: A Biochemical and Histological Study

Background/Objectives: Despite advances in ulcer treatment research, the search for new, safe, and effective strategies for preventing and treating ulcer diseases persists. Methods: In this study, the protective effects of dietary supplementation with krill oil (KO), fish oil (FO), and astaxanthin (ASX) on an ethanol-induced gastric ulcer model were compared during biochemical and histological observations. Sprague–Dawley (n = 64) rats randomly divided into four groups—normal control (vehicle), KO, FO, and ASX groups—received the supplements via the orogastric route at a rate of 2.5% (v/w) of their daily feed consumption for 4 weeks. Then, ulcer induction was performed with ethanol. Results: The ulcer group showed increased levels of malondialdehyde (MDA), chemiluminescence (CL), and myeloperoxidase (MPO) activity and decreased levels of glutathione in the gastric tissues. While KO, FO, and ASX supplementation decreased chemiluminescence levels in the ulcer group, only ASX supplementation decreased MDA levels and MPO activity. Conclusions: In conclusion, supplementation with KO or FO has a similar protective effect against ethanol-induced ulcer damage, as it inhibits ROS formation and reduces lipid peroxidation. However, ASX supplementation has a higher protective effect than KO or FO supplementations against experimental ethanol-induced gastric lesions in rats, as it inhibits ROS formation and reduces neutrophil infiltration and lipid peroxidation.

Experimental study on radiational characteristics and nursing care of a novel radioisotope 188Re memory alloy esophageal stent.

Radioactive esophageal stent, known for inhibiting tumor growth and delaying restenosis in malignant esophageal tumors, presents challenges due to potent radiation, leading to side effects. This study aims to support the clinical use of 188Re radioactive esophageal stent. The 188Re stent with 128MBq initial activity was placed in a biomimetic esophageal membrane. Radiation absorption doses were measured by thermoluminescence and calculated using mathematical software. Under simulated positioning, the stent was implanted in the esophagus of an experimental pig, followed by the feeding of Kangfuxin solution and nursing care (KFX-RT). Non-implanted and implanted-only pigs served as normal (CR) and experimental (RT) controls. Blood samples collected on days 7 and 21 were analyzed for inflammatory factors (TGF-β1, TNF-α, IL-6) using enzyme-linked immunosorbent assay. Esophageal tissue cells were assessed for deoxyribonucleic acid index (DI) and subdiploid content through flow cytometry. Absorbed doses at 0.5mm and 5mm reference points were 223.91cGy and 20.55cGy, respectively, with 92.64% absorbed within a 1mm thickness. Radiation dose significantly decreased at 6.5mm, with only 4.72% absorbed at depths ≥6.5mm. On days 7 and 21, levels of inflammatory factors, DI and subdiploid content were significantly increased in the KFX-RT and RT groups compared to the CR group, while all levels in the KFX-RT group were significantly lower than in the RT group. The 188Re esophageal stent exhibits high radiation absorption in superficial tissues and low absorption in deeper tissues. Kangfuxin solution combined with nursing care alleviates radiation-induced inflammatory damage.

Urine is better for rare earth elements bimonitoring in long-term exposed population: An exposure-response relationship study

With the soaring use of rare earth elements (REEs) worldwidely in high-technology and clean energy industries, there were growing concerns for adverse health effect from the REEs exposure. However, there is a lack of biomonitoring research concerning both urine and blood in population with definite exposure. We performed a biomonitoring study that involved 103 REEs exposed males and 110 males as non-REEs exposed controls. We measured the levels of REEs in environment and urine and blood samples from participants, and explored the exposure-response relationship between REEs in environment and body fluids. The effects of exposure duration and smoking status on the internal exposure level of REEs were also investigated. The results showed environmental REEs level of exposure group was significantly higher than that of control group (range of geometric mean of exposure vs. control: 1.08-4.07 × 104 ng/m3 vs. <LOD-2.16 × 102 ng/m3). Six elements with detection rates higher than 60% in blood or urine samples were lanthanum (La), cerium (Ce), praseodymium (Pr), neodymium (Nd), samarium (Sm), gadolinium (Gd). We found the REEs concentrations both in urine and blood of exposure population were significantly higher than controls, median range of the above 6 elements of urine and blood was 0.02–1.06 μmol/mol vs. <LOD-0.01 μmol/mol creatinine and 0.01–0.79 μg/L vs. <LOD-0.38 μg/L. The correlations between both blood and urine level of REEs and environment level showed significant. The correlation coefficients with urine levels are higher than with blood. Biomonitoring results showed good exposure-response relationship in urine REEs, while no positive response in blood samples. Smoking status, drinking status and years of exposure showed little effect on the level of REEs. Our results suggested that both blood and urine can be used to monitor REEs exposure, while urinary REEs is promising for risk assessment in population.