Scientific Rationale Research Articles

Temporal, spatial and demographic distributions characteristics of COVID-19 symptom clusters from chinese medicine perspective: a systematic cross-sectional study in China from 2019 to 2023

BackgroundThe subtypes diagnosis of disease symptom clusters, grounded in the theory of “Treatment in Accordance with Three Categories of Etiologic Factors” and International Classification of Diseases 11th Revision (ICD-11), is a vital strategy for Chinese Medicine (CM) in treating unknown respiratory infectious diseases. However, the classification of disease symptom clusters continues to depend on empirical observations and lacks robust scientific evidence. Consequently, this study seeks to explore the temporal, spatial and demographic distributions characteristics of Corona Virus Disease 2019 (COVID-19) symptom clusters in China.MethodsPubMed, Web of Science, Science direct, WHO, Litcovid, CNKI databases were searched from inception until December 31, 2023. Optical character recognition technology and image recognition technology were employed to identify tables within the papers. Four researchers independently screened and extracted data, resolving conflicts through discussion. Heat mapping and hierarchical clustering techniques were utilized to analyze COVID-19 symptom clusters. Data analysis and visualization were conducted using R software (4.2.0), while the association analysis of symptom clusters was performed using Cytoscape (3.10.2).ResultsA total of 366 COVID-19 clinical trials with 86,972 cases including 66 clinical symptoms of 7 disease systems and other clinical manifestations in China were included. In temporal distribution, 63 symptoms centered around fatigue and 44 symptoms focused on chest tightness are characteristic of symptom clusters in spring and winter, respectively. With the addition of spatial distribution, the symptom clusters in middle and low latitudes during spring are characterized by 53 symptoms centered around fatigue and cough, and 51 symptoms focused on fatigue, respectively. During winter, the symptom clusters in middle and low latitudes are characterized by 38 symptoms centered around chest tightness and 37 symptoms focused on fever, respectively. When considering demographic distribution, the symptom clusters for < 50 years are characterized by fatigue as the core symptom in middle (44 symptoms)/low (28 symptoms) latitudes during spring and middle latitude (25 symptoms) during winter. For ≥ 50 years, the symptom clusters in middle latitude (49 symptoms) during spring and low latitudes (35 symptoms) during winter are centered around cough, while in low latitude (27 symptoms) focuses on diarrhea during spring, and middle latitude (35 symptoms) emphasizes both diarrhea and chest tightness during winter.ConclusionIn summary, variations in symptom clusters and core symptoms of COVID-19 in temporal, spatial and demographic distributions in China offer a scientific rationale for the “Treatment in Accordance with Three Categories of Etiologic Factors” theory. These interesting findings prompt further investigation into CM patterns in the ICD-11, and suggest potential strategies for personalized precision treatment of COVID-19. High-quality clinical studies focusing on individual symptoms are warranted to enhance understanding of respiratory infectious diseases.

Spirituality and Contemplative States Through Yoga Practices: The Scientific Rationale and Preliminary Evidence

Spirituality and Contemplative States Through Yoga Practices: The Scientific Rationale and Preliminary Evidence

Making the case for community involvement in research on climate and health: opportunities and lessons

Advancing climate change is an urgent global driver of human disease with some of the world’s most marginalized communities being at highest risk. In response to this compound threat, scientific studies exploring the intersections of climate and health are gaining momentum, yet sparse attention is currently paid to models of research that engage and involve those who are most affected. This is a crucial moment for the global health field to take up valuable lessons from the relatively few climate-health studies that have purposefully brought scientists together with communities and members of the wider public, via established approaches such as community-based participatory research and citizen science, to reduce health risks and better understand the deeper determinants of disease. Through a scoping literature review of PubMed and qualitative framework analysis, we investigate scientific, ethical, and social justice rationales that have motivated scientists to involve communities, including Indigenous groups, and other public stakeholders in climate-driven health research to varying degrees in different global contexts. We also examine the benefits of diverse forms of engagement and show that involving communities in research at the climate-health nexus has, for example, generated co-produced adaptation strategies that respond appropriately and effectively to priority health hazards. In addition, our findings demonstrate limitations, challenges, and ethical considerations that can arise when engaging communities in climate-health research. We argue that ethically engaging and involving communities and the wider public in research at the intersection of climate change and health is imperative for identifying relevant research priorities, promoting responsiveness that can appropriately fill gaps in at-risk settings, and advancing social justice. Our paper offers a range of examples of research designs and activities to guide scientists working in this emerging interdisciplinary field, inform funders seeking to support innovative and potentially transformative research, and contribute to global health policy.

Shen-Qi-Di-Huang Decoction induces autophagy in podocytes to ameliorate membranous nephropathy by suppressing USP14.

Shen-Qi-Di-Huang decoction (SQDHD) is a renowned decoction in traditional Chinese medicine, dating back to the Qing Dynasty. SQDHD has been widely applied in treating renal diseases, including Membranous nephropathy (MN), with its proven positive clinical outcomes. Nevertheless, the precise mechanism by which SQDHD exerts its therapeutic effects on MN remains uncertain. The present research aimed to observe whether SQDHD promotes podocyte autophagy by inhibiting USP14 to increase the K63 ubiquitination of Beclin1, thereby improving MN. An MN model was established in rats using Passive Heyman Nephritis (PHN) to explore the underlying mechanisms in vivo. The kidney function parameters were evaluated, and the histomorphology of glomerular tissues was examined. Autophagy-related protein expression was assessed using immunofluorescence staining and western blotting assays. Co-immunoprecipitation (Co-IP) was used to detect the K63 ubiquitination of Beclin1. MPC5 cells were treated in vitro with serum obtained from several rat groups. Subsequently, the expression of autophagy-related proteins, formation of autophagosomes, expression of USP14, and K63 ubiquitination of Beclin1 were quantified. Our results demonstrated that SQDHD intervention reduced urinary protein levels, mitigated podocyte damage in MN model rats, and improved kidney tissue pathology. Furthermore, in vitro and in vivo data revealed that SQDHD therapy significantly increased podocyte autophagy, decreased USP14 expression, and raised Beclin1's K63 ubiquitination. These results provided a scientific rationale supporting the ability of SQDHD to substantially alleviate MN progression by inducing podocyte autophagy through the inhibition of USP14 expression.

Prolonged antithrombotic treatment after de-escalation of dual antiplatelet therapy in patients after acute coronary syndrome - which strategy should be applied? The ELECTRA-SIRIO 2 investigators standpoint.

De-escalation of dual antiplatelet (DAPT) intensity may be considered in patients with high risk of bleeding after acute coronary syndrome. Some high risk patients after de-escalation may require antithrombotic therapy prolonged over 12 months. With the current guideline recommended strategies, there are some doubts and uncertainties with respect to the transition period. Herein we discuss these issues more extensively. De-escalation of DAPT, intended to decrease bleeding risk, may be accomplished by switching to a drug with reduced antiplatelet effect (de-escalation by switching), by reducing the dose (de-escalation by dose reduction), or by removing an antiplatelet agent (de-escalation by discontinuation). The dilemma concerns patients who have undergone scheduled, early de-escalation of DAPT to monotherapy with a P2Y12 receptor inhibitor at standard dose, as in the TWILIGHT study. The dilemma is even greater in patients whose de-escalation consisted of both reduction in dose of one and discontinuation of the other antiplatelet agent. This strategy is currently being tested in the ELECTRA-SIRIO 2 study. When making a therapeutic decision in patients who meet the criteria for prolonged dual antithrombotic therapy we suggest considering the previously applied DAPT de-escalation strategy. In general, unless the risk of ischemic events has increased since prior de-escalation, there is no scientific rationale for escalating antithrombotic treatment in a patient previously de-escalated (through reduction or discontinuation). Regardless of the treatment strategy, its effectiveness depends on the patient's adherence to medical recommendations.

The Sequelae of Sleeping Issues and their Management in Post COVID- 19: A Unani and Contemporary Narrative Review

Background: The Coronavirus disease (COVID-19) impacted not only physical health but also psychological health, including anxiety, depressive symptoms, and sleep issues. Disrupted sleep has now become a global concern and burden in the post-COVID period of recovery. The Unani system of medicine elaborated on sleeping issues and their management during the pandemic. However, the claims of the Unani system and its medications in improving the various domains of sleep quality during the revival period have not been investigated. Materials and Methods: A search of electronic databases on Pub Med, Scopus, Web of Science, and CINAHL, on sleep disorders, post-COVID-19 and a manual search of Unani classical text related to sleep quality improvement methods was conducted. Results: Recent scientific evidence has found a positive association between COVID-19 and sleep disorders. Unani medicine suggests improvement of sleep issues by maintaining six essential factors, dieto-therapy, pharmacotherapy, and regimens (like Nutool (irrigation), Hamam (Turkish bath), and Dalk (massage). Several pre-clinical and clinical trials done on Unani herbs (single and poly-herbal preparations) have elucidated the scientific rationale for improving sleep quality. Conclusion: Unani therapy has sufficient potential for improving sleep outcomes for COVID-19 patients as they are efficacious, safe and affordable therapeutic options. Additionally, there is still a need for evidence to support the validity of Unani psychotherapy as a multifaceted and holistic approach.

Fundamentals of a healthy and sustainable diet

BackgroundA healthy and sustainable diet is a prerequisite for population and planetary health. The evidence of associations between dietary patterns and health outcomes has now been synthesised to inform more than 100 national dietary guidelines. Yet, people select foods, not whole dietary patterns, even in the context of following specific diets such as a Mediterranean diet, presenting challenges to researchers, policymakers and practitioners wanting to translate dietary guideline recommendations into food-level selection guidance for citizens. Understanding the fundamentals that underpin healthy and sustainable diets provides a scientific basis for helping navigate these challenges. This paper’s aim is to describe the fundamentals of a healthy and sustainable diet.ResultsThe scientific rationale underpinning what is a healthy and sustainable diet is universal. Everyone shares a physiological need for energy and adequate amounts, types and combinations of nutrients. People source their energy and nutrient needs from foods that are themselves sourced from food systems. The physiological need and food systems’ sustainability have been shaped through evolutionary and ecological processes, respectively. This physiological need can be met, and food systems’ sustainability protected, by following three interlinked dietary principles: (i) Variety – to help achieve a nutritionally adequate diet and help protect the biodiversity of food systems. (ii) Balance – to help reduce risk of diet-related non-communicable diseases and excessive use of finite environmental resources and production of greenhouse gas emissions. (iii) Moderation – to help achieve a healthy body weight and avoid wasting finite environmental resources used in providing food surplus to nutritional requirements.ConclusionThe fundamentals of a healthy and sustainable diet are grounded in evolutionary and ecological processes. They are represented by the dietary principles of variety, balance and moderation and can be applied to inform food-level selection guidance for citizens.

Microbiome-Centered Therapies for the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant global health issue, affecting over 30% of the population worldwide due to the rising prevalence of metabolic risk factors such as obesity and type 2 diabetes mellitus (T2DM). This spectrum of liver disease ranges from isolated steatosis to more severe forms such as steatohepatitis, fibrosis, and cirrhosis. Recent studies highlight the role of gut microbiota in MASLD pathogenesis, showing that dysbiosis significantly impacts metabolic health and the progression of liver disease. This review critically evaluates current microbiome-centered therapies in MASLD management, including prebiotics, probiotics, synbiotics, fecal microbiota transplantation (FMT), and emerging therapies such as engineered bacteria and bacteriophage therapy. We explore the scientific rationale, clinical evidence, and potential mechanisms by which these interventions influence MASLD. The gut-liver axis is crucial in MASLD, with notable changes in microbiome composition linked to disease progression. For instance, specific microbial profiles and reduced alpha diversity are associated with MASLD severity. Therapeutic strategies targeting the microbiome could modulate disease progression by improving gut permeability, reducing endotoxin-producing bacteria, and altering bile acid metabolism. Although promising, these therapies require further research to fully understand their mechanisms and optimize their efficacy. This review integrates findings from clinical trials and experimental studies, providing a comprehensive overview of microbiome-centered therapies' potential in managing MASLD. Future research should focus on personalized strategies, utilizing microbiome features, blood metabolites, and customized dietary interventions to enhance the effectiveness of these therapies.

Pharmacodynamics of the S1P1 receptor modulator cenerimod in a phase 2b randomised clinical trial in patients with moderate to severe SLE

BackgroundSystemic lupus erythematosus (SLE) is a complex autoimmune disease characterised by autoreactive T and B lymphocytes. Sphingosine-1-phosphate (S1P) is involved in lymphocyte egress from peripheral lymphoid organs into the circulation....

Quality aspects during pine resin storage: Appearance deterioration, turpentine chemical components change, kinetic model and insights into isomerization mechanisms

Pine resin is a promising natural resource with various industrial applications and economic value. However, the quality of pine resin deteriorates during storage, resulting in a decline in the quality of rosin and turpentine. This study compares the effects of deionized and surface water, as well as deionized and surface water containing 5 % impurities, on the quality of pine resin over a six-month storage period. The color of pine resin was evaluated using the CIE L*a*b* color space, and the softening point and acid value of rosin and the refractive index of turpentine obtained from the distillation of pine resin were examined. Furthermore, the alterations in the chemical constitution of turpentine were examined through GC-MS. The results demonstrated that the appearance of pine resin gradually deteriorated with increasing storage time. The acid value and softening point are within normal limits (159 ∼ 170 mg/g, approximately 75 °C), and the color of rosin begins to redden, yellow, and darken with time, with a maximum deterioration to grade 5 at 6 months. The refractive index of turpentine gradually increased with time, from 1.4661 to 1.4687, after 6 months of storage. The pinene content declined, with a maximum decrease of 51.88 % at 6 months. In addition, the network diagram was constructed, which delineates the reaction pathways of pinene during storage. The isomerization of α-pinene and β-pinene produces monocyclic terpenoids, primarily including p-cymene and isoterpinolene. A first-order kinetic model was constructed to describe the mechanism of the transformation of α-pinene and β-pinene. The results provided a scientific rationale for further endeavors to enhance the quality of pine resin and associated commodities during the storage.

Sustainable bonds as a sustainable financial instrument: thematic insights and future prospects

Purpose This study aims to explore the development and significance of sustainable finance instruments, mainly sustainable bonds. The purpose is to provide policymakers, regulators and researchers with insights into the current state of sustainable finance research and also provide future research directions. Design/methodology/approach This study used Scientific Procedures and Rationales for Systematic Literature Reviews as a review protocol and addressed four research questions concerning publication and citation trends, major themes and future research directions in sustainable bonds. Findings This study indicated growing attention in sustainable bond research, with increasing publication and citation trends. Along with identifying research themes, the findings include future direction on pricing and risk assessment, market dynamics and growth potential, policy and regulatory environments and global perspectives with local context. Research limitations/implications Although this study provides a robust analysis of the current literature, it relies on existing publications and may not capture the latest developments in sustainable bond research. However, policymakers can benefit from insights into the growth and dynamics of sustainable bonds, enabling them to implement effective policies and regulations. Investors and businesses can use this research to inform their environmental, social and governance investment strategies and decision-making processes. Originality/value This paper suggests a comprehensive overview of the state of research in sustainable bonds, highlighting the emerging trends and research priorities. It also underlines the significance of sustainable finance in achieving sustainability goals and provides a roadmap for future research.

Electrical shock injuries: an analysis of voltage, frequency, and contact mode determinants

This article examines the precision of medical terminology commonly used to diagnose and understand the pathogenesis of electrical shock injuries. As everyday technology increasingly depends on advanced electrical mechanisms that utilize more efficient modes of electrical energy transmission, waveforms, and frequencies, emergency and trauma physicians will continue to encounter a broader array of electrical injury manifestations. This phenomenon prompts a closer examination of the diagnostic terminology associated with electrical shocks. The pathogenesis of electrical injury depends on the tissue electric field strength, frequency, current duration, and tissues involved. Some traditional diagnostic terms, for example, “entry” and “exit” wounds, arc-flash burns, and “high-voltage” and “low-voltage” electrical injuries, obscure the complexity of this pathogenesis, likely impeding medical management and advances in electrical safety science. This article presents the scientific rationale for suggested changes to medical terminology and aims to encourage future refinement.

Exploring the impact of digital knowledge, integration and performance on sustainable accounting, reporting and assurance

Purpose The purpose of this study is to perform bibliometric analysis to systematically and comprehensively examine the current landscape of digital knowledge, integration and performance in the transformation of sustainability accounting, reporting and assurance. Design/methodology/approach This research uses a systematic literature review, following the Scientific Procedures and Rationales for Systematic Literature Review protocol and uses various bibliometric and performance analytical methods. These include annual scientific production analysis, journal analysis, keyword cooccurrence analysis, keyword clustering, knowledge gap analysis and future research direction identification to evaluate the existing literature thoroughly. Findings The analysis reveals significant insights into the transformative impact of digital technologies on sustainability practices. Annual scientific production and journal analyses highlight key contributors to the adoption of digital technologies in sustainability accounting, reporting and assurance. Keyword cooccurrence analyses have identified key themes in sustainability accounting, reporting and assurance, highlighting the transformative role of digital technologies such as artificial intelligence (AI), blockchain, Internet of Things (IoT) and big data. These technologies enhance corporate accountability, transparency and sustainability by automating processes and improving data accuracy. The integration of these technologies supports environmental, social and governance (ESG) reporting, circular economy initiatives and strategic decision-making, fostering economic, social and environmental sustainability. Cluster-by-coupling analyses delve into nine broader revealing that IoT improves ESG report accuracy, eXtensible Business Reporting Language structures ESG data and AI enhances life cycle assessments and reporting authenticity. In addition, digital transformation impacts environmental performance, big data optimizes resource use and edge computing improves eco-efficiency. Furthermore, this study identifies avenues for future research to advance the understanding and implementation of digital technology in sustainability accounting, reporting and assurance practices. Research limitations/implications Academically, this research enriches the understanding of how digital technologies shape sustainability practices and identifies gaps in digital knowledge and integration. Practically, it provides actionable insights for organizations to improve sustainability reporting and performance by effectively leveraging these technologies. Policy-wise, the findings advocate for frameworks supporting the effective implementation of these technologies, ensuring alignment with global sustainability goals. Originality/value This study offers a detailed analysis of the performance and intellectual framework of research on implementing digital technology in sustainability accounting, reporting and assurance. It highlights the evolving research landscape and emphasizes the need for further investigation into how emerging technologies can be leveraged to achieve sustainability goals.

Identifying and overcoming challenges in the EMA's qualification of novel methodologies: a two-year review.

The EMA Qualification of Novel Methodologies procedure qualifies methods, technologies and methodologies within a well-defined context of use in a pharma R&D context based on the evaluation of the presented scientific rationale and submitted data. This policy brief analyses QoNM submissions providing policy messages and recommendations to stakeholders on how to better prepare qualification applications in this regard. The recommendations include: 1. Grounding validation strategy using a current standard measure or a distribution technique. 2. Accurately represent pertinent subgroups via accurate inclusion and exclusion criteria. 3. Establish a well-defined and specific CoU with clear descriptions of the use within a development program target population and disease stage. Lastly, it emphasizes role of the QoNM procedure in advancing medicine development methodologies within the EU.

Design of CONQUEST, a novel, randomized, placebo-controlled, Phase 2b platform clinical trial to investigate new treatments for patients with early active systemic sclerosis with interstitial lung disease.

Safe, effective therapies are urgently needed for patients with systemic sclerosis. However, clinical trial recruitment is challenging given the limited number of people with systemic sclerosis and further restrictions imposed by eligibility criteria. Innovative approaches are needed to accelerate development of new therapies. This article describes the rationale and trial design for CONQUEST (NCT06195072), a novel platform clinical trial sponsored by the Scleroderma Research Foundation, a not-for-profit organization. CONQUEST is a multicentre, double-blind, randomized, placebo-controlled, Phase 2b platform trial evaluating the efficacy, safety and pharmacodynamics of multiple investigational products to treat early active systemic sclerosis with interstitial lung disease versus placebo. The primary objective is to evaluate change from baseline to Week 52 in forced vital capacity (mL). Secondary objectives include evaluating changes from baseline to Week 52 in high-resolution computed-tomography-assessed lung involvement and dyspnoea, and overall treatment response (measured using the revised composite response index in diffuse systemic sclerosis score in participants with diffuse cutaneous systemic sclerosis). Patients will be enrolled across more than 150 centres in over 25 countries. Recruitment started on 15 April 2024. As the first platform clinical trial in the rheumatology field, CONQUEST aims to meaningfully accelerate the development of new therapies for early active systemic sclerosis. Depending on regimen-specific results, trial data could be used to plan and design a Phase 3 trial or may be used alone or together with another registrational trial to establish substantial evidence of effectiveness and safety. The first molecules to be studied, amlitelimab and nerandomilast, both have a strong scientific rationale to modify underlying disease processes in systemic sclerosis. Platform Clinical Study for Conquering Scleroderma (CONQUEST); NCT06195072; https://www.clinicaltrials.gov/study/NCT06195072.

Advancing Heart Failure Treatment: The Role of Multipoint Pacing in Cardiac Resynchronization Therapy

Cardiac resynchronization therapy (CRT) with biventricular pacing is a standard therapy for patients with heart failure, reduced ejection fraction, and electrical dyssynchrony. However, approximately 30% of patients do not respond to CRT. Multipoint pacing (MPP) has emerged as an innovative strategy that paces multiple left ventricular sites to achieve more comprehensive resynchronization. This review explores the evolution of MPP, including the underlying scientific rationale, clinical evidence from key trials, technological considerations of quadripolar leads and programmability, patient selection criteria, optimization strategies, and future directions. Early feasibility studies demonstrated acute hemodynamic improvements with MPP. Larger trials have shown superior outcomes with MPP compared to conventional biventricular pacing, including increased CRT response rates, reduced hospitalizations, and improved ejection fraction and reverse remodeling. However, recent multicenter trials found no significant differences between the population's MPP and biventricular pacing. Ongoing research aims to refine patient selection for MPP and optimize lead positioning and programming configurations to maximize benefits. As technological capabilities expand, MPP promises to provide tailored, physiological pacing therapies that may enhance outcomes for heart failure patients requiring CRT. This comprehensive review examines the various aspects of MPP, including its scientific foundation, clinical evidence, technological considerations, impact on patient quality of life, and future implications. By critically assessing the current literature and identifying gaps in knowledge, we aim to provide a thorough understanding of MPP’s role in the evolving landscape of heart failure management.

Biological effects of combinations of structurally diverse human milk oligosaccharides.

Human milk oligosaccharides (HMOs) are a diverse group of structures and an abundant bioactive component of breastmilk that contribute to infant health and development. Preclinical studies indicate roles for HMOs in shaping the infant gut microbiota, inhibiting pathogens, modulating the immune system, and influencing cognitive development. In the past decade, several industrially produced HMOs have become available to fortify infant formula. Clinical intervention trials with manufactured HMOs have begun to corroborate some of the physiological effects reported in preclinical studies, especially modulation of the gut microbiota in the direction of breastfed infants. As more HMOs become commercially available and as HMOs have some shared mechanisms of action, there is a need to better understand the unique and differential effects of individual HMOs and the benefits of combining multiple HMOs. This review focuses on the differential effects of different HMO structural classes and individual structures and presents a scientific rationale for why combining multiple structurally diverse HMOs is expected to exert greater biological effects.

The closed fishing season policy in Ghana: Lessons from the coastal fisherfolk

Although the socio-economic significance of fishing is globally recognized, the protection of fish stock has not been adequately attended to in fisheries management, leading to fishing practices that threaten the sustainability of fish stock. This study examined the Closed Fishing Season (CFS) policy adopted in Ghana to reduce the excessive pressure on fish stock to ensure the sustainability of fishing-related livelihoods. Data were collected through interviews and focus group discussions with 80 participants, comprising coastal fisherfolk as critical stakeholders, traditional authorities, technocrats, and an academic in fisheries. The data were analysed thematically. The findings revealed that whereas the academic and technocrats had a scientific justification for the policy, the fisherfolk took a cultural view of it without necessarily discounting the scientific rationale. Compliance with the policy was high but there were isolated cases of violations occasioned principally by livelihood pressures. The fisherfolk perceived the livelihood support packages provided by the government to be inadequate, unfairly distributed, and untimely delivered. Also, they perceived their participation in decision-making to be low. Based on the fact that their expectation of a bumper catch immediately after the CFS was not met, the fisherfolk described the effectiveness of the policy to be weak. Although the fisherfolk were not opposed to the policy in principle, they maintained that it was more important to address issues of corruption in the distribution of premix fuel, plastic waste, trans-shipment, proliferation of fishing vessels, use of chemicals and light for fishing, and other illegal, unregulated, and unreported (IUU) fishing practices. Adopting the co-management approach in addressing issues of alternative livelihoods, IUUs, and misconceptions, coupled with a strategic integration of scientific and indigenous knowledge in the design and implementation of the policy would enhance its effectiveness.

The impact of fibre and prebiotic interventions on outcomes in cancer and haematopoietic stem cell transplantation: a systematic review

Background & aimsCancer therapy is associated with a range of toxicities that severely impact patient well-being and a range of clinical outcomes. Dietary fibre/prebiotics characteristically improve the gastrointestinal microenvironment, which consequently elicits beneficial downstream effects that could be relevant to the prevention and management of treatment-related toxicities. Despite the compelling theoretical scientific rationale there has been limited effort to synthesise the available evidence to conclude such scientific underpinning to the clinical use of fibre/prebiotics in cancer patients. Therefore, this systematic review aimed to evaluate the clinical impact of fibre/prebiotic-based interventions on gastrointestinal-side effects; gastrointestinal-microbiome; clinical outcomes; nutrition status and body composition; and quality-of-life in children and adults being treated for cancer or undergoing a haematopoietic stem cell transplant (HSCT). MethodsThis study was conducted in adherence to PRISMA guidelines, and the protocol was published prospectively with PROSPERO (CRD42022299428). Three databases (MEDLINE (Ovid), CINHAL, EMBASE) were searched from inception to December 2023. All articles were assessed for bias using the Cochrane risk-of-bias tool RoB 2.0 (for RCTs) and ROBINS-I (for non-RCTs). ResultsA total of 9989 de-duplicated records were identified, of these, 14 (paediatrics [n= 1], adults [n=13]) met the inclusion criteria (randomised controlled trials (RCT) [n = 11], observational or non-RCTs [n = 3]). The risk-of-bias was graded to be serious/high (n=6); moderate/some concerns (n=7); low (n=1). Interventions included prebiotic supplement (n=8), nutrition supplement/formula with added fibre/prebiotic (n=3) and dietary modification (n=3). The dose of fibre intervention ranged from 2.4g-30g per day. Substantial heterogeneity of target parameters was identified across a range all outcome categories, precluding definitive conclusions. ConclusionThe scientific rationale for fibre/prebiotics-based interventions for the prevention or management of cancer treatment-related toxicities is compelling. However, it is clear that the scientific and clinical field remains disconnected in how to effectively translate this approach to improve cancer outcomes. High-quality intervention studies translatable to clinical practice are now evidently crucial to determine if and how fibre/prebiotics should be used to support people undergoing cancer or HSCT therapy.

Curiosity in Consumer Behavior: A Systematic Literature Review and Research Agenda

ABSTRACTThe aim of this study is to conduct a systematic review of the literature on consumer curiosity and its impact on consumer behavior. The “Scientific Procedures and Rationales for Systematic Literature Reviews” (SPAR‐4‐SLR) methodology and the “Theory, Context, Characteristics, and Methodology” (TCCM) framework were employed to analyze 122 papers published between 1992 and 2024. Articles were selected from the Web of Science database using key terms related to consumer curiosity. Consumer curiosity is a complex phenomenon that influences various aspects of consumer behavior, including purchase decisions, consumer engagement, and adaptation to new technologies. Curiosity serves as a significant moderator and mediator in consumer interactions with the market, especially in the context of new technologies such as AI and VR. The findings of this review indicate a growing interest in studying consumer curiosity in recent years, as reflected by the increasing number of publications. The practical implications of the analysis are significant for various stakeholders. Businesses can leverage these findings to develop more effective marketing strategies that engage consumers by stimulating their curiosity. Understanding how curiosity influences decision‐making can also aid in the development of innovative products and services that better meet consumers' unmet needs. Additionally, academic researchers can build on the theoretical frameworks related to consumer curiosity and design future research based on identified gaps. Finally, managers and marketing professionals can apply these insights to personalize shopping experiences and enhance consumer engagement, which can lead to increased brand loyalty and competitive advantage. This review emphasizes the need for further research on the role of curiosity in consumer behavior and its impact on product innovation and marketing strategies and provides recommendations for future research directions that could contribute to a deeper understanding of how curiosity shapes consumer interactions with brands and products.