Bioactive Nb2C MXene-Functionalized Hydrogel with Microenvironment Remodeling and Enhanced Neurogenesis to Promote Skeletal Muscle Regeneration and Functional Restoration.

The complete structure-functional repair of volumetric muscle loss (VML) remains a giant challenge and biomedical hydrogels to remodel microenvironment and enhance neurogenesis have appeared to be a promising direction. However, the current hydrogels for VML repair hardly achieve these two goals simultaneously due to their insufficient functionality and the challenge in high-cost of bioactive factors. In this study, a facile strategy using Nb2C MXene-functionalized hydrogel (OPTN) as a bioactive scaffold is proposed to promote VML repair with skeletal muscle regeneration and functional restoration. In vitro experiments show that OPTN scaffold can effectively scavenge reactive oxygen species (ROS), guide macrophages polarization toward M2 phenotype, and resist bacterial infection, providing a favorable microenvironment for myoblasts proliferation as well as the endothelial cells proliferation, migration, and tube formation. More importantly, OPTN scaffold with electroactive feature remarkably boosts myoblasts differentiation and mesenchymal stem cells neural differentiation. Animal experiments further confirm that OPTN scaffold can achieve a prominent structure-functional VML repair by attenuating ROS levels, alleviating inflammation, reducing fibrosis, and facilitating angiogenesis, newborn myotube formation, and neurogenesis. Collectively, this study provides a highly promising and effective strategy for the structure-functional VML repair through designing bioactive multifunctional hydrogel with microenvironment remodeling and enhanced neurogenesis.

Nanoporous, Ultrastiff, and Transparent Plastic-like Polymer Hydrogels Enabled by Hydrogen Bonding-Induced Self-Assembly.

Most natural supporting tissues possess both exceptional mechanical strength, a significant amount of water, and the anisotropic structure, as well as nanoscale assembly. These properties are essential for biological processes, but have been challenging to emulate in synthetic materials. In an effort to achieve simultaneous improvement of these trade-off features, a hydrogen bonding-induced self-assembly strategy was introduced to create nanoporous plastic-like polymer hydrogels. Multiple hydrogen bonding-mediated networks and nanoporous orientation structures endow transparent hydrogels with remarkable mechanical robustness. They exhibit Young's modulus of up to 223.7 MPa and a breaking strength of up to 10.3 MPa, which are superior to those of most common polymer hydrogels. The uniform porous nanostructures of hydrogen-bonded hydrogels contribute to a significantly larger specific surface area compared to conventional hydrogels. This allows for the retention of high mechanical properties in environments with a high water content of 70 wt %. A rubbery stage is observed during the heating process, which can reverse and reshape the manufacture of objects with various desired 2D or 3D shapes using techniques such as origami and kirigami. Finally, as a proof-of-concept, the outstanding mechanical properties of poly(MAA-co-AA-co-NVCL) hydrogel, combined with its high water content, make it suitable for applications such as smart temperature monitors, multilevel information anticounterfeiting, and artificial muscles.

Clinical Comparison between HD-tDCS and tDCS for Improving Upper Limb Motor Function: A Randomized, Double-Blinded, Sham-Controlled Trial.

Background: Stroke is a common and frequently occurring disease among middle-aged and elderly people, with approximately 55%-75% of patients remaining with upper limb dysfunction. How to promote the recovery of motor function at an early stage is crucial to the life of the patient. Objectives: This study aimed to investigate whether high-definition transcranial direct current stimulation (HD-tDCS) of the primary motor cortex (M1) functional area in poststroke patients in the subacute phase is more effective in improving upper limb function than conventional tDCS. Methods: This randomized, sham-controlled clinical trial included 69 patients with subcortical stroke. They were randomly divided into the HD-tDCS, anodal tDCS (a-tDCS), and sham groups. Each group received 20 sessions of stimulation. The patients were assessed using the Action Research Arm Test, Fugl-Meyer score for upper extremities, Motor Function Assessment Scale, and modified Barthel index (MBI) pretreatment and posttreatment. Results: The intragroup comparison scores improved after 4 weeks of treatment. The HD-tDCS group showed a slightly greater, but nonsignificant improvement as compared to a-tDCS group in terms of mean change observed in function of trained items. The MBI score of the HD-tDCS group was maintained up to 8 weeks of follow-up and was higher than that in the a-tDCS group. Conclusion: Both HD-tDCS and a-tDCS can improve upper limb motor function and daily activities of poststroke patients in the subacute stage. This trial is registered with ChiCTR2000031314.

Revealing Surface/Interface Chemistry of the Ordered Aramid Nanofiber/MXene Structure for Infrared Thermal Camouflage and Electromagnetic Interference Shielding.

The past decade has witnessed the advances of infrared (IR) thermal camouflage materials, but challenges remain in breaking the trade-off nature between emissivity and mechanical properties. In response, we identify the key role of a moderate reprotonation rate in the aramid nanofiber (ANF)/MXene film toward a surface-to-bulk alignment. Theoretical simulation demonstrates that the ordered ANF/MXene surface eliminates the local high electric field by field confinement and localization, responsible for the low IR emissivity. By scrutinizing the surface/interface chemistry, the processing optimization is achieved to develop an ordered and densely stacked ANF/MXene film, which features a low emissivity of 16%, accounting for sound IR thermal camouflage performances including a wide camouflage temperature range of 50-200 °C, a large reduction in radiation temperature from 200.5 to 63.6 °C, and long-term stability. This design also enables good mechanical performance such as a tensile strength of 190.8 MPa, a toughness of 12.1 MJ m-3, and a modulus of 7.9 GPa, responsible for better thermal camouflage applications. The tailor-made ANF/MXene film further attains an electromagnetic interference (EMI) shielding effectiveness (40.4 dB) in the X-band, manifesting its promise for IR stealth compatible EMI shielding applications. This work will shed light on the dynamic topology reconstruction of camouflage materials for boosting thermal management technology.

Resveratrol inhibits ferroptosis via activating NRF2/GPX4 pathway in mice with spinal cord injury.

Ferroptosis is a newly defined form of cell death involved in neurologic disease. Resveratrol is a non-flavonoid polyphenolic compound with anti-inflammatory and antioxidant properties, but its potential therapeutic mechanism in spinal cord injury (SCI) remains unknown. Therefore, this study evaluates the mechanism by which resveratrol promotes neurological and motor function recovery in mice with SCI. The motor function of mice was evaluated using the Basso Mouse Scale score and footprint test. The effect of resveratrol on the neuronal cell state was observed using NeuN, fluoro-Jade C, and Nissl staining. The expression of iron content in injured segments was observed using Perls blue and Diaminobenzidine staining. The effect of resveratrol on the levels of malondialdehyde, glutathione, Fe2+ , and glutathione peroxidase 4 enzyme activity was also investigated. The mitochondrial ultrastructures of injured segment cells were observed using transmission electron microscope, while the protein levels of ferroptosis-related targets were detected using Western blot. Our findings show that resveratrol improves motor function after SCI and has certain neuroprotective effects; in ferroptosis-related studies, resveratrol inhibited the expression of ferroptosis-related proteins and ions. Resveratrol improved changes in mitochondrial morphology. Mechanistically, the Nrf2 inhibitor ML385 reversed the inhibitory effect of resveratrol on ferroptosis-related genes, indicating that resveratrol inhibits ferroptosis through the Nrf2/GPX4 pathway. Our findings elucidate that resveratrol promotes functional recovery, inhibits ferroptosis post-SCI, and provides an experimental basis for subsequent clinical translational research. Our study shows that resveratrol inhibits the production of lipid peroxide and the accumulation of iron by activating Nrf2/GPX4 signaling pathway, thereby inhibiting neuronal ferroptosis. At the same time, it can promote the recovery of motor function of mice.

Hydrogen Bonding Enables Polymer Hydrogels with pH-Induced Reversible Dynamic Responsive Behaviors.

Poly(acrylic acid-co-N-vinylcaprolactam) (PAN) hydrogels containing multiple hydrogen bonds can exhibit pH-induced reversible dynamic responsive behaviors. When placing a transparent hydrogel in an acid bath, as hydrogen bonds between comonomer units involving protonated COOH groups are formed faster than water diffusion, a nonequilibrium light-scattering state is formed to turn the hydrogel opaque, while as the swelling equilibrium is reached over time, the hydrogel regains its transparency. Likewise, when the transparent, hydrogen-bonded hydrogel is subsequently immersed in DI water, faster water absorption occurs in where more COOH groups are deprotonated, which also generates a light-scattering state leading to opacity, while the transparency is slowly recovered after equilibrium. Using such two-way dynamic transparency evolution, a PAN-based hydrogel material is prepared to demonstrate a dynamic memory system for information memorizing-forgetting and recalling-forgetting.

The role of purinergic receptors in neural repair and regeneration after spinal cord injury.

Spinal cord injury is a serious injury of the central nervous system that results in neurological deficits. The pathophysiological mechanisms underlying spinal cord injury, as well as the mechanisms involved in neural repair and regeneration, are highly complex. Although there have been many studies on these mechanisms, there is no effective intervention for such injury. In spinal cord injury, neural repair and regeneration is an important part of improving neurological function after injury, although the low regenerative ability of nerve cells and the difficulty in axonal and myelin regeneration after spinal cord injury hamper functional recovery. Large amounts of ATP and its metabolites are released after spinal cord injury and participate in various aspects of functional regulation by acting on purinergic receptors which are widely expressed in the spinal cord. These processes mediate intracellular and extracellular signalling pathways to improve neural repair and regeneration after spinal cord injury. This article reviews research on the mechanistic roles of purinergic receptors in spinal cord injury, highlighting the potential role of purinergic receptors as interventional targets for neural repair and regeneration after spinal cord injury.

Corrigendum: Neurofeedback training of alpha relative power improves the performance of motor imagery brain-computer interface.

[This corrects the article DOI: 10.3389/fnhum.2022.831995.].

Effect of Acupuncture Treatment on Post-stroke Depression by Using Diamond-Like Ultra-Thin Nano-Coating Technology.

This study aimed to explore the effect of acupuncture on account of composite diamond-like nano-membrane sensors (DLNF) sensors on post-stroke depression. Titanium/antigen-diamond-like carbon (Ti/Ag-DLC) composite DLNF sensors were prepared by coating Ti and Ag composites on the surface of DLC by radio frequency magnetron sputtering technology. The scanning electron microscope (SEM), X-ray photoelectron spectrometer (XPS), Raman spectrometer, nanoindenter, and sliding friction tester were adopted to analyze the characterization of Ti/Ag-DLC composite membrane, the chemical state of the main constituent elements on the surface, structural characteristics, membrane hardness, and tribological properties, respectively. 132 patients with post-stroke depression in our hospital were selected as the research objects, they were divided into the control group (receiving conventional treatment) and the acupuncture group (receiving acupuncture based on conventional treatment) according to different treatment methods, with 66 cases in each group. The depression of the two groups of patients before the treatment and 4 and 8 weeks after the treatment were compared. The psychological resilience scale and Herth scale were used to evaluate the mental toughness and hope level of patients. The results showed that when the Ag content was less than 0.55%, the Ti/Ag-DLC composite surface was smooth and showed no obvious particles, the membranes with different content had obvious absorption peaks at 1560 cm-1 and the friction life in a high vacuum environment was extended to around 900 revolutions. After 4 and 8 weeks of treatment, the scores of the hammer depression scale (HDS) in the two groups were significantly lower than before treatment (P<0.01) and the scores of the acupuncture group were much lower after 4 and 8 weeks of treatment in contrast to the control group (P<0.01). The optimism, self-strength, and tenacity in the psychological resilience scale of the acupuncture group patients rose higher than those in the control group (P<0.05) after 8 weeks of treatment. The Herth scale score of the acupuncture group was greatly higher compared with that of the control group after 8 weeks of treatment (P<0.01). It showed that the Ti/Ag-DLC composite DLNF sensor with good hardness and friction performance was prepared in this study. Acupuncture therapy could improve the negative emotions of patients with post-stroke depression, enhance mental resilience, and help raise the level of hope. Therefore, it was proved to be a potentially effective treatment.

Phototherapy for Cognitive Function in Patients With Dementia: A Systematic Review and Meta-Analysis.

Background: Dementia is a major health burden worldwide. As numerous pharmacological trials for dementia have failed, emerging phototherapy studies have evaluated the efficacy of alternative therapies for cognition. Objective: The objective of this study was to evaluate the association between phototherapy and changes in cognitive deficits in patients with dementia. Methods: PubMed, Embase, Web of Science, PsycINFO, CINAHL, and Cochrane Central Register of Controlled Trials were searched from inception to 27 March 2022. Inclusion criteria were controlled clinical trials of phototherapy interventions reporting pre-post changes in global cognitive function and subdomains in patients with dementia. Data were extracted by two independent reviewers and pooled in random-effects models. Subgroup and meta-regression analyses were conducted to investigate the sources of heterogeneity. Results: Our analyses included 13 studies enrolling a total of 608 participants. Phototherapy showed significant associations with improvements of global cognitive function (standardized mean difference [SMD], 0.63; 95% confidence interval [CI], 0.33-0.94; P < 0.001) and subdomains, especially with respect to attention, executive function, and working memory. Near-infrared (NIR) light-emitting diodes (LEDs) photobiomodulation (SMD, 0.91; 95% CI, 0.46-1.36; P < 0.001) and lasers (SMD, 0.99; 95% CI, 0.56-1.43; P < 0.001) showed more significant associations with improved cognitive functions when compared with normal visible light. In addition, the effect sizes of short-term effects (SMD, 0.63; 95% CI, 0.33-0.94; P < 0.001) were larger than effects assessed in long-term follow-up (SMD, 0.49; 95% CI, -0.24-1.21; P = 0.189). Conclusion: In this meta-analysis, phototherapy interventions were associated with cognitive improvement in patients with dementia. NIR LEDs and lasers had advantages over normal visible light. Domain-specific effects were indicated for attention, executive function, and working memory. Short-term improvement after phototherapy was supported, while evidence for long-term benefits was lacking. Stronger evidence for individualized parameters, such as optimal dosing, is needed in the future. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=267596], identifier [CRD42021267596].

[The measurements of the similarity of dynamic brain functional network].

Brain functional network changes over time along with the process of brain development, disease, and aging. However, most of the available measurements for evaluation of the difference (or similarity) between the individual brain functional networks are for charactering static networks, which do not work with the dynamic characteristics of the brain networks that typically involve a long-span and large-scale evolution over the time. The current study proposes an index for measuring the similarity of dynamic brain networks, named as dynamic network similarity (DNS). It measures the similarity by combining the "evolutional" and "structural" properties of the dynamic network. Four sets of simulated dynamic networks with different evolutional and structural properties (varying amplitude of changes, trend of changes, distribution of connectivity strength, range of connectivity strength) were generated to validate the performance of DNS. In addition, real world imaging datasets, acquired from 13 stroke patients who were treated by transcranial direct current stimulation (tDCS), were used to further validate the proposed method and compared with the traditional similarity measurements that were developed for static network similarity. The results showed that DNS was significantly correlated with the varying amplitude of changes, trend of changes, distribution of connectivity strength and range of connectivity strength of the dynamic networks. DNS was able to appropriately measure the significant similarity of the dynamics of network changes over the time for the patients before and after the tDCS treatments. However, the traditional methods failed, which showed significantly differences between the data before and after the tDCS treatments. The experiment results demonstrate that DNS may robustly measure the similarity of evolutional and structural properties of dynamic networks. The new method appears to be superior to the traditional methods in that the new one is capable of assessing the temporal similarity of dynamic functional imaging data.

Neurofeedback Training of Alpha Relative Power Improves the Performance of Motor Imagery Brain-Computer Interface.

Significant variation in performance in motor imagery (MI) tasks impedes their wide adoption for brain-computer interface (BCI) applications. Previous researchers have found that resting-state alpha-band power is positively correlated with MI-BCI performance. In this study, we designed a neurofeedback training (NFT) protocol based on the up-regulation of the alpha band relative power (RP) to investigate its effect on MI-BCI performance. The principal finding of this study is that alpha NFT could successfully help subjects increase alpha-rhythm power and improve their MI-BCI performance. An individual difference was also found in this study in that subjects who increased alpha power more had a better performance improvement. Additionally, the functional connectivity (FC) of the frontal-parietal (FP) network was found to be enhanced after alpha NFT. However, the enhancement failed to reach a significant level after multiple comparisons correction. These findings contribute to a better understanding of the neurophysiological mechanism of cognitive control through alpha regulation.

P2Y2 Receptor Mediated Neuronal Regeneration and Angiogenesis to Affect Functional Recovery in Rats with Spinal Cord Injury.

The aim of this study was to investigate the effect of the P2Y2 receptor (P2Y2R) signaling pathway on neuronal regeneration and angiogenesis during spinal cord injury (SCI). The rats were randomly divided into 3 groups, including the sham+dimethyl sulfoxide (DMSO), SCI+DMSO, and SCI+P2Y2R groups. The SCI animal models were constructed. A locomotor rating scale was used for behavioral assessments. The apoptosis of spinal cord tissues was detected by TUNEL staining. The expression levels of P2Y2R, GFAP, nestin, Tuj1, and CD34 were detected by immunofluorescence staining, and the expression levels of TNF-α, IL-1ß, and IL-6 were detected by enzyme-linked immunosorbent assay. The locomotor score in the model group was significantly lower than the sham group. The expression of P2Y2R was increased after SCI. The expression levels of TNF-α, IL-1ß, and IL-6 were increased remarkably in the SCI model group compared with the sham group. The P2Y2R inhibitor relieved neuronal inflammation after SCI. Compared with the sham group, the apoptotic rate of spinal cord tissue cells in the model group was significantly increased. The P2Y2R inhibitor reduced the apoptosis of the spinal cord tissue. The expressions of CD34, Tuj1, and nestin in the model group were decreased, while the expressions of GFAP and P2Y2R were increased. The P2Y2R inhibitor reversed their expression levels. The P2Y2R inhibitor could alleviate SCI by relieving the neuronal inflammation, inhibiting the spinal cord tissue apoptosis, and promoting neuronal differentiation and vascular proliferation after SCI. P2Y2R may serve as a target for the treatment of SCI.

Porous Liquid-Crystalline Networks with Hydrogel-Like Actuation and Reconfigurable Function.

A porous liquid-crystalline network (LCN), prepared by using a template method, was found to exhibit peculiar actuation functions. The creation of porosity makes the initially hydrophobic LCN behave like a hydrogel, capable of absorbing a large volume of water (up to ten times the sample size of LCN). When the amount of absorbed water is relatively small (about 100 % swelling ratio), the porous LCN displays anisotropic swelling in water and, in the same time, the retained uniaxial alignment of mesogens ensures a thermally induced shape change associated with a LC-isotropic phase transition. Combining the characteristic actuation mechanisms of LCN (order-disorder transition of mesogens) and hydrogel (water absorption), such porous LCNs can be explored for versatile stimuli-triggered shape transformations. Moreover, the porosity enables loading/removal/reloading of functional fillers such as ionic liquids, photothermal dyes and fluorophores, which imparts the porous LCN actuator with reconfigurable functions such as ionic conductivity, light-driven locomotion, and emissive color.

Fixel-based evidence of microstructural damage in crossing pathways improves language mapping in Post-stroke aphasia.

BACKGROUND: The complex crossing-fiber characteristics in the dual-stream system have been ignored by traditional diffusion tensor models regarding disconnections in post-stroke aphasia. It is valuable to identify microstructural damage of crossing-fiber pathways and reveal accurate fiber-specific language mapping in patients with aphasia. METHODS: This cross-sectional study collected magnetic resonance imaging data from 29 participants with post-stroke aphasia in the subacute stage and from 33 age- and sex-matched healthy controls. Fixel-based analysis was performed to examine microstructural fiber density (FD) and bundle cross-section alterations of specific fiber populations in crossing-fiber regions. Group comparisons were performed, and relationships with language scores were assessed. RESULTS: The aphasic group exhibited significant fixel-wise FD reductions in the dual-stream tracts, including the left inferior fronto-occipital fasciculus (IFOF), arcuate fasciculus, and superior longitudinal fasciculus (SLF) III (family-wise-error-corrected p < 0.05). Voxel- and fixel-wise comparisons revealed mismatched distributions in regions with crossing-fiber nexuses. Fixel-wise correlation analyses revealed significant associations between comprehension impairment and reduced FD in the temporal and frontal segments of the left IFOF, and also mapped naming ability to the IFOF. Average features along the whole course of dominant tracts assessed with tract-wise analyses attributed word-level comprehension to the IFOF (r = 0.723, p < 0.001) and revealed a trend-level correlation between sentence-level comprehension and FD of the SLF III (r = 0.451, p = 0.021). The mean FD of the uncinate fasciculus (UF) and IFOF correlated with total and picture naming scores, and the IFOF also correlated with responsive naming subdomains (Bonferroni corrected p < 0.05). CONCLUSIONS: FD reductions of dual streams suggest that intra-axonal volume reduction constitutes the microstructural damage of white matter integrity in post-stroke aphasia. Fixel-based analysis provides a complementary method of language mapping that identifies fiber-specific tracts in the left hemisphere language network with greater specificity than voxel-based analysis. It precisely locates the precise segments of the IFOF for comprehension, yields fiber-specific evidence for the debated UF-naming association, and reveals dissociative subdomain associations with distinct tracts.

Correlations between Dual-Pathway White Matter Alterations and Language Impairment in Patients with Aphasia: A Systematic Review and Meta-analysis.

While converging evidence suggests linguistic roles of white matter tracts, detailed associations between white matter alterations of dual pathways and language abilities remain unknown in aphasic patients. We aimed to verify language functions of dual-pathway tracts from specific domains and investigate the influence of moderators. PubMed, Web of Science, Embase, and CENTRAL were searched for studies published between January 1, 1985 and March 17, 2019. A meta-analysis of 46 studies including 1353 aphasic patients was performed by pooling correlation coefficients between linguistic domains and diffusion metrics of dual-pathway tracts. Among these tracts, the fractional anisotropy (FA) value of the left inferior fronto-occipital fasciculus predominated across most linguistic aspects, showing the strongest correlations with global severity, comprehension, naming and reading ability. The left uncinate fasciculus and inferior longitudinal fasciculus also showed significant FA - comprehension correlations. For syntactic processing, FA values of the left superior longitudinal fasciculus and arcuate fasciculus showed significant positive correlations. Meta-regression revealed no influence of etiology on FA - language correlations, while sex had a moderating effect on the FA - comprehension correlation of the arcuate fasciculus, and age influenced the FA - naming correlation in the superior longitudinal fasciculus. In conclusion, multifunctional characteristics of tracts were revealed in aphasic patients, including broad linguistic associations of the inferior fronto-occipital fasciculus, and repetition and syntactic involvement of the arcuate fasciculus. Language associations of the inferior longitudinal fasciculus and uncinate fasciculus were clarified regarding comprehension subdomains. The insignificant moderating effect of the etiology indicates damage of dual pathways is the common neural mechanism, while sex and age influence the correlation with comprehension and naming ability, respectively, in specific tracts.

A novel fully immersive virtual reality environment for upper extremity rehabilitation in patients with stroke.

Given the rising incidence of stroke, several technology-driven methods for rehabilitation have recently been developed. Virtual reality (VR) is a promising therapeutic technology among them. We recently developed a neuroscientifically grounded VR system to aid recovery of motor function poststroke. The developed system provides unilateral and bilateral upper extremity (UE) training in a fully immersive virtual environment that may stimulate and activate mirror neurons (MNs) in the brain necessary for UE rehabilitation. Twenty-three participants were randomized to a VR group (n = 12) to receive VR intervention (8 h within 2 weeks) plus 8-h occupational therapy (OT) or a control group (n = 11) to receive time-matched OT alone. Treatment effects on motor recovery and cortical reorganization were investigated using the Barthel Index (BI), Fugl-Meyer Upper Extremity (FM-UE), and resting-state fMRI. Both groups significantly improved BI (P < 0.05), reflecting the recovery of UE motor function. The VR group revealed significant improvements on FM-UE scores (P < 0.05) than the control group. Neural activity increased after the intervention, particularly in the brain areas implicating MNs, such as in the primary motor cortex. Overall, results suggested that using a neuroscientifically grounded VR system might offer additional benefits for UE rehabilitation in patients receiving OT.

Comparative Efficacy and Patient-Specific Moderating Factors of Nonsurgical Treatment Strategies for Frozen Shoulder: An Updated Systematic Review and Network Meta-analysis.

BACKGROUND: Frozen shoulder is a common shoulder disorder characterized by pain and restriction. Various nonsurgical treatments have been reported, but there is no consensus about their comparative efficacy and the effects of moderators. PURPOSE: To compare the efficacy of different nonsurgical interventions and identify potential patient-specific moderating factors for frozen shoulder. STUDY DESIGN: Systematic review and network meta-analysis. METHODS: PubMed, Embase, Cochrane Library, and Web of Science databases were searched from their inception to February 18, 2019. The search was supplemented by manual review of relevant reference lists. Randomized controlled trials of participants with frozen shoulder that compared nonsurgical interventions were selected. Measured outcomes included pain, shoulder function in daily activities, and range of motion. RESULTS: Of 3136 records identified, 92 trials were eligible, evaluating 32 nonsurgical interventions in 5946 patients. Intra-articular injection improved pain (pooled standardized mean difference [95% CI]: steroid injection, 1.68 [1.03-2.34]; capsular distension, 2.68 [1.32-4.05]) and shoulder function (steroid injection, 2.16 [1.52-2.81]; distension, 2.89 [1.71-4.06]) to a greater extent than placebo. Capsular distension and extracorporeal shockwave therapy showed the highest ranking for pain relief and functional improvement, respectively. Laser therapy also showed benefits for pain relief (3.02 [1.84-4.20]) and functional improvement (3.66 [1.65-5.67]). Subgroup analyses by disease stages revealed that steroid injection combined with physical therapy provided more benefits during the freezing phase, whereas joint manipulation provided more benefits in the adhesive phase. Adjunctive therapies, female sex, and diabetes were also identified as moderators of effectiveness. CONCLUSION: Capsular distension is a highly recommended choice for treatment of frozen shoulder, contributing greatly to pain relief and functional improvement; steroid injection is also a prevailing effective intervention. Among new options, extracorporeal shockwave therapy and laser therapy show potential benefits for multiple outcomes. Individualized optimal intervention should be considered, given that treatment effect is moderated by factors including the disease stage, time of assessment, adjunctive therapies, female sex, and diabetes.

Long-term persistence of anti-HBs after hepatitis B vaccination among isolated anti-HBc positive adults in China: 8-years results.

The long-term persistence of hepatitis B surface antibody (anti-HBs) after hepatitis B vaccination among adults harboring isolated hepatitis B core antibody (anti-HBc) is not yet clarified. The present study aimed to assess the immunogenicity and persistence of antibodies in adults 8 years after vaccination. A total of 309 participants including 94 participants in the isolated anti-HBs group and 215 in the control group were recruited in this study. All subjects received three doses of hepatitis B vaccine (20 µg) at 0, 1, and 12 months, followed by testing for serological responses 1 month after the third vaccination. Subsequently, 154 participants were excluded because their anti-HBs data of 8 y after the first vaccination were missing. The prevalence of isolated anti-HBc was about 11.5%, the positive seroprotection rate was 72%, and the geometric mean titer (GMT) value of anti-HBs titer was 24.55 mIU/mL in the isolated anti-HBc group 8 y after three doses of vaccination. No significant difference was detected in the positive seroprotection rate (P = .434) and the GMT values of anti-HBs titers (P = .674) between the isolated anti-HBc and control groups after 8 y. In conclusion, isolated anti-HBc-positive subjects could achieve satisfactory long-term immune effects after hepatitis B vaccination. The GMT values of anti-HBs titers were lower than those of the control group at 1 month, but no significant difference was detected after 8 years.

Therapeutic iminoboronate-based polymersomes with a Cu(ii)-mediated Fenton reaction-enhanced ROS-response.

Reactive oxygen species (ROS)-responsive prodrug nanoplatforms may not work efficiently due to insufficient ROS concentrations, so therapeutic polymersomes of a metallisable triamine-centered iminoboronate-functionalized amphiphilic starlike prodrug (N3-(OEG-IBCAPE)4) are prepared to show a Cu(ii)-mediated Fenton reaction-enhanced ROS response.