Spatial confinement: An effective strategy to improve H2O and SO2 resistance of the expandable graphite-modified TiO2-supported Pt nanocatalysts for CO oxidation.

The expandable graphite (EG) modified TiO2 nanocomposites were prepared by the high shear method using the TiO2 nanoparticles (NPs) and EG as precursors, in which the amount of EG doped in TiO2 was 10 wt.%. Followed by the impregnation method, adjusting the pH of the solution to 10, and using the electrostatic adsorption to achieve spatial confinement, the Pt elements were mainly distributed on the exposed TiO2, thus generating the Pt/10EG-TiO2-10 catalyst. The best CO oxidation activity with the excellent resistance to H2O and SO2 was obtained over the Pt/10EG-TiO2-10 catalyst: CO conversion after 36 hr of the reaction was ca. 85% under the harsh condition of 10 vol.% H2O and 100 ppm SO2 at a high gaseous hourly space velocity (GHSV) of 400,000 hr-1. Physicochemical properties of the catalysts were characterized by various techniques. The results showed that the electrostatic adsorption, which riveted the Pt elements mainly on the exposed TiO2 of the support surface, reduced the dispersion of Pt NPs on EG and achieved the effective dispersion of Pt NPs, hence significantly improving CO oxidation activity over the Pt/10EG-TiO2-10 catalyst. The 10 wt.% EG doped in TiO2 caused the TiO2 support to form a more hydrophobic surface, which reduced the adsorption of H2O and SO2 on the catalyst, greatly inhibited deposition of the TiOSO4 and formation of the PtSO4 species as well as suppressed the oxidation of SO2, thus resulting in an improvement in the resistance to H2O and SO2 of the Pt/10EG-TiO2-10 catalyst.

An Auto-Reading probe system for detecting deletion mutations In liquid biopsy with direct quantification of mutation abundance.

Background: Deletion mutations have been confirmed to be closely related to the occurrence and progression of different hereditary diseases and tumors. Specifically, the deletion of a small number of bases is more challenging to be captured and differentiated. In non-invasive prenatal testing (NIPT) and liquid biopsy targeting circulating tumor DNA, obtaining accurate mutation abundance in targeted DNA is a crucial step in the detection process. However, the quantification of mutation abundance with existing methods is not accurate enough. Results: Herein, we developed the " Auto-Reading" probe detection system based on our previous work. Through theoretical modeling and experimental calculations, we verified the successful application of our system in NIPT and early cancer diagnosis, enabling effective discrimination of different mutant abundances. Significance: Our method overcomes the interference of reaction concentrations on signal detection, allowing direct quantification of mutation abundance without the need for purification of PCR products. The detection system is cost-effective and feasible for laboratory use. We believe the system will facilitate broad applications in mutation detection.

[Impact of GuttaFlow Bioseal sealer on the vertical fracture resistance of oval-shaped canals].

PURPOSE: To investigate the effect of GuttaFlow Bioseal root canal sealer on the vertical root fracture resistance of oval-shaped root canals. METHODS: Sixty orthodontically subtracted maxillary and mandibular single-rooted premolar teeth were scanned with CBCT. Oval canals were eligible when the buccolingual diameter of the canal was greater than or equal to two times the mesiodistal diameter at a distance of 5 mm from the root apex. Thirty single-rooted premolars with oval-shaped root canals were prepared to F2 using the Protaper system and then randomly divided into the GuttaFlow Bioseal filling group and iRoot SP filling group. Each group was further divided for root canal filling using warm vertical compression, cold lateral condensation and single cone techniques. Five single-rooted premolars was chosen as a negative control group. After 30 days of storage in a constant thermotank at 37 ℃ and 100% humidity, the filled roots were vertically placed into a cylindrical model of self-polymerizing acrylic resin. Subsequently, the samples were fixed on the lower plate of a universal testing machine, and a ball of 4 mm in diameter was applied vertically with a downward pressure at a speed of 1 mm/min until fracture occurred. The load values were recorded in Newtons. The data were analyzed using SPSS 29.0 software package. Fracture patterns were examined under microscope. RESULTS: T test results showed no significant difference between the GuttaFlow Bioseal-filled and iRoot SP-filled groups (P=0.321). One-way ANOVA showed a significant difference in vertical fracture resistance between the groups(P＜0.05), and LSD analysis showed that the GuttaFlow Bioseal-filled sample teeth were significantly more resistant to vertical fracture than the iRoot SP when using the thermal vertical compression filling method and the single-tip method(P＜0.05). In contrast, the GuttaFlow BIoseal-filled group was significantly less resistant to vertical fracture than the iRoot SP group when using the cold lateral compression filling method(P＜0.05). CONCLUISIONS: GuttaFlow Bioseal has the potential to improve root resistance to vertical fracture when filling root canals using the thermal vertical pressurization method and the single-tip method, but more clinical trials are needed to validate this result and its long-term prognosis.

Evaluating the impact of evolving green and grey urban infrastructure on local particulate pollution around city square parks.

The relationship between green and grey urban infrastructure, local meteorological conditions, and traffic-related air pollution is complex and dynamic. This case study examined the effect of evolving morphologies around a city square park in Dublin and explores the twin impacts of local urban development (grey) and maturing parks (green) on particulate matter (PM) pollution. A fixed air quality monitoring campaign and computational fluid dynamic modelling (ENVI-met) were used to assess current (baseline) and future scenarios. The baseline results presented the distribution of PM in the study area, with bimodal (PM2.5) and unimodal (PM10) diurnal profiles. The optimal vegetation height for air quality within the park also differed by wind direction with 21 m vegetation optimal for parallel winds (10.45% reduction) and 7 m vegetation optimal for perpendicular winds (30.36% reduction). Increased building heights led to higher PM2.5 concentrations on both footpaths ranging from 25.3 to 37.0% under perpendicular winds, whilst increasing the height of leeward buildings increased PM2.5 concentrations by up to 30.9% under parallel winds. The findings from this study provide evidence of the importance of more in-depth analysis of green and grey urban infrastructure in the urban planning decision-making process to avoid deteriorating air quality conditions around city square parks.

Clinical significance of preoperative nutritional status in elderly gastric cancer patients undergoing radical gastrectomy: A single-center retrospective study.

BACKGROUND: The population of elderly patients with gastric cancer is increasing, which is a major public health issue in China. Malnutrition is one of the greatest risk factors for adverse clinical outcomes in elderly patients with gastric cancer. AIM: To investigate the preoperative nutritional status and its association with delayed discharge of elderly gastric cancer patients following radical gastrectomy. METHODS: A total of 783 patients aged 65 years and older harboring gastric adenocarcinoma and following radical gastrectomy were retrospectively analyzed from the prospectively collected database of Zhongshan Hospital of Fudan University between January 2018 and May 2020. RESULTS: The overall rate of malnutrition was 31.8%. The incidence of postoperative complications was significantly higher in the malnourished group compared to the well-nourished group (P < 0.001). Nutritional characteristics in the malnourished group, including body mass index, prognostic nutritional index (PNI), albumin, prealbumin, and hemoglobin, were all significantly lower than those in the well-nourished group. The percentage of patients who received postoperative total nutrient admixture was lower in the malnourished group compared to the well-nourished group (22.1% vs 33.5%, P = 0.001). Age ≥ 70 years (HR = 1.216, 95%CI: 1.048-1.411), PNI < 44.5 (HR = 1.792, 95%CI: 1.058-3.032), operation time ≥ 160 minutes (HR = 1.431, 95%CI: 1.237-1.656), and postoperative complications grade III or higher (HR = 2.191, 95%CI: 1.604-2.991) were all recognized as independent risk factors associated with delayed discharge. CONCLUSION: Malnutrition is relatively common in elderly patients undergoing gastrectomy. Low PNI is an independent risk factor associated with delay discharge. More strategies are needed to improve the clinical outcome of these patients.

Silvaticusins A-D: ent-kaurane diterpenoids and a cyclobutane-containing ent-kaurane dimer from Isodon silvaticus.

Three new ent-kaurane diterpenoids, silvaticusins A-C (1-3), along with a new ent-kaurane dimer silvaticusin D (4) were isolated from the aerial parts of Isodon silvaticus. The structures of these new compounds were established mainly by comprehensive analysis of their NMR and MS data. The absolute configuration of compounds 1 and 4 were determined using a single-crystal X-ray diffraction and computational methods, respectively. Compounds 2 and 3 were found to exhibit remarkable cytotoxic effects against five human tumor cell lines (HL-60, A-549, SMMC-7721, MDA-MB-231, and SW-480), with IC50 values spanning from 1.27 ± 0.08 to 7.52 ± 0.33 µM.

Telehealth-Supported Exercise or Physical Activity Programs for Knee Osteoarthritis: Systematic Review and Meta-Analysis.

BACKGROUND: The integration of telehealth-supported programs in chronic disease management has become increasingly common. However, its effectiveness for individuals with knee osteoarthritis (KOA) remains unclear. OBJECTIVE: This study aimed to assess the effectiveness of telehealth-supported exercise or physical activity programs for individuals with KOA. METHODS: A comprehensive literature search encompassing Embase, MEDLINE, CENTRAL, Web of Science, PubMed, Scopus, PEDro, GreyNet, and medRxiv from inception to September 2023 was conducted to identify randomized controlled trials comparing telehealth-supported exercise or physical activity programs to a control condition for KOA. Data were extracted and qualitatively synthesized across eligible studies, and a meta-analysis was performed to evaluate the effects. The study was reported according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020. RESULTS: In total, 23 studies met eligibility criteria, with 20 included in the meta-analysis. Results showed that telehealth-supported exercise or physical activity programs reduced pain (g=-0.39; 95% CI -0.67 to -0.11; P<.001), improved physical activity (g=0.13; 95% CI 0.03-0.23; P=.01), and enhanced physical function (g=-0.51; 95% CI -0.98 to -0.05; P=.03). Moreover, significant improvements in quality of life (g=0.25; 95% CI 0.14-0.36; P<.001), self-efficacy for pain (g=0.72; 95% CI 0.53-0.91; P<.001), and global improvement (odds ratio 2.69, 95% CI 1.41-5.15; P<.001) were observed. However, self-efficacy for physical function (g=0.14; 95% CI -0.26 to 0.53; P=.50) showed insignificant improvements. Subgroup analyses based on the World Health Organization classification of digital health (pain: χ22=6.5; P=.04 and physical function: χ22=6.4; P=.04), the type of teletechnology in the intervention group (pain: χ24=4.8; P=.31 and function: χ24=13.0; P=.01), and active or inactive controls (pain: χ21=5.3; P=.02 and physical function: χ21=3.4; P=.07) showed significant subgroup differences. CONCLUSIONS: Telehealth-supported exercise or physical activity programs might reduce knee pain and improve physical activity, physical function, quality of life, self-efficacy, and global improvement in individuals with KOA. Future research should consider longer implementation durations and assess the feasibility of incorporating wearables and standardized components into large-scale interventions to evaluate the effects. TRIAL REGISTRATION: PROSPERO CRD42022359658; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=359658.

miR-27a-3p promotes inflammatory response in infectious endophthalmitis via targeting TSC1.

Infectious endophthalmitis (IE) poses a significant threat to vision. This study aimed to explore the impact of microRNA (miR)-27a-3p on inflammation in IE. A rat model was developed through intravitreal injection of lipopolysaccharide. Clinical and demographic data were collected for 54 participants: 31 diagnosed with IE and 23 non-infectious patients with idiopathic macular holes. Expression levels of miR-27a-3p and inflammatory genes were quantified via reverse transcription quantitative polymerase chain reaction. Concentrations of inflammatory cytokines in human vitreous samples were measured using enzyme-linked immunosorbent assay. In vitro studies were conducted to explore the target gene of miR-27a-3p. The final animal experiments further verified the role of miR-27a-3p and tuberous sclerosis complex (TSC)1 in inflammatory responses. Results showed that miR-27a-3p was elevated in LPS-treated rats and IE patients. Thirty-one IE patients were divided into the High (n = 15) and Low (n = 16) groups according to the expression of miR-27a-3p. No significant differences were observed in baseline clinical and demographic characteristics between the control and IE patient groups. Pro-inflammatory cytokine mRNA levels and concentrations were notably increased in both LPS-treated rats and the High group of patients. Besides, results showed that TSC1 is a target gene of miR-27a-3p. Moreover, TSC1 inhibition promoted inflammation in rat vitreous samples. In summary, our findings suggested that miR-27a-3p exacerbated inflammatory responses in IE though targeting TSC1, offering novel insights for potential therapeutic strategies targeting miR-27a-3p in the clinical management of IE.

Assessing the impact of climate warming on tree species composition and distribution in the forest region of Northeast China.

Global climate change has markedly influenced the structure and distribution of mid-high-latitude forests. In the forest region of Northeast China, the magnitude of climate warming surpasses the global average, which presents immense challenges to the survival and habitat sustainability of dominant tree species. We predicted the potential changes in aboveground biomass, dominant tree species composition, and distribution in the forest region of Northeast China over the next century under different climatic conditions encompassing the current scenario and future scenarios (RCP2.6, RCP4.5, and RCP8.5). Forest ecosystem process model LINKAGES 3.0 was used to simulate dynamic changes in species-level aboveground biomass under four climate scenarios at the homogeneous land-type unit level. The potential spatial distribution of tree species was investigated based on three indicators: extinction, colonization, and persistence. The results showed that LINKAGES 3.0 model effectively simulated the aboveground biomass of 17 dominant tree species in the forest region of Northeast China, achieving a high accuracy with R² = 0.88. Under the current, RCP2.6, and RCP4.5 climate scenarios, the dominant tree species presented gradual increases in aboveground biomass, whereas under RCP8.5, an initial increase and subsequent decline were observed. With increasing warming magnitude, cold-temperate coniferous tree species will gradually be replaced by other temperate broad-leaved tree species. Furthermore, a large temperature increase under RCP8.5 will likely produce a significant contraction in the potential distribution range of tree species like Larch, Scotch pine, Ribbed birch, Spruce and Fir, while most temperate broad-leaved tree species and Korean pine are expected to demonstrate a northward migration. These findings provide guidance for enhancing the adaptability and resilience of forest ecosystems in middle and high latitudes and addressing the threats posed by climate warming.

Analysis of maxillary teeth and soft tissue profiles among Tibetan and Han Chinese females with facial symmetry for orthodontic treatment planning.

The evaluation of maxillary teeth and soft tissue profiles is a critical component of orthodontic diagnosis and treatment planning. This study aimed to evaluate the correlation between the sagittal position of maxillary anterior teeth and facial profile esthetics among Tibetan and Han Chinese adult females for optimizing orthodontic diagnosis and treatment planning. A total of 100 Tibetan Chinese and 100 Han Chinese adult females with good facial symmetry were recruited. The smiling facial profile images with the maxillary central incisors and forehead in full view were taken based totally on the same standard. The photo measurement and head position were adjusted using the picture-enhancing software. The reference traces associated with forehead inclinations were utilized to assess the anteroposterior (AP) positions of the maxillary central incisors. The results showed that a round forehead was the dominant forehead shape for Tibetan (93%) and Han (55%) Chinese females. In Tibetan females, 85% of the maxillary central incisors were found to be located between the forehead's anterior limit line (the Gall line) and the goal anterior limit line (the Fall line), with 15% located posterior to the Fall line. This distribution manifested a strong association with incisor position and forehead inclination (R2 = 0.742). In Han females, 83% of the maxillary central incisors were located between the Fall line and the Gall line, with 12% posterior to the Fall line and 5% anterior to the Gall line. The positions of the maxillary central incisors exhibited a strong relationship with forehead inclination (R2 = 0.827). The maxillary central incisors were close to the aesthetic line in both ethnic groups, while forehead inclinations were correlated with AP maxillary incisor position. These findings demonstrated that there was a close relationship between the incisor position of Tibetan and Han females with facial symmetry and the forehead FFA factor, indicating a reference in oral hard and soft tissues for optimizing orthodontic diagnosis and treatment planning in terms of facial contour.

SAGN: Sparse Adaptive Gated Graph Neural Network With Graph Regularization for Identifying Dual-View Brain Networks.

Due to the absence of a gold standard for threshold selection, brain networks constructed with inappropriate thresholds risk topological degradation or contain noise connections. Therefore, graph neural networks (GNNs) exhibit weak robustness and overfitting problems when identifying brain networks. Furthermore, existing studies have predominantly focused on strongly coupled connections, neglecting substantial evidence from other intricate systems that highlight the value of weakly coupled connections. Consequently, the potential of weakly coupled brain networks remains untapped. In this study, we pioneeringly construct weakly coupled brain networks and validate their values in emotion identification tasks. Subsequently, we propose a sparse adaptive gated GNN (SAGN) that can simultaneously perceive the valuable topology of dual-view (i.e., strongly coupled and weakly coupled) brain networks. The SAGN contains a sparse adaptive global receptive field. Moreover, SAGN employs a gated mechanism with feature enhancement and adaptive noise suppression capabilities. To address the lack of inductive bias and the large capacity of SAGN, a graph regularization term built with prior topology of dual-view brain networks is introduced to enhance generalization. Besides a public dataset (SEED), we also built a custom dataset (MuSer) with 60 subjects to evaluate weakly coupled brain networks' value and validate the SAGN's performance. Experiments demonstrate that brain physiological patterns associated with different emotional states are separable and rooted in weakly coupled brain networks. In addition, SAGN exhibits excellent generalization and robustness in identifying brain networks.

Synthesis of Bridged Five-Membered Ring Systems by Type II [3 + 2] Annulation of Allenylsilane-ene.

The first type II intramolecular [3 + 2] annulation of allenylsilane-ene has been achieved, enabling diastereoselective and efficient construction of synthetically challenging bridged five-membered ring systems such as bicyclo[3.2.1]. This mild and direct process shows a broad substrate scope and is highly stereospecific. Particularly, this work represents the first stereoselective method for the direct synthesis of bicyclo[3.2.1] ring systems from acyclic precursors. Additionally, the first asymmetric total syntheses of (+)- and (-)-strepsesquitriol, and the efficient formation of the synthetically challenging tetracyclic core of pierisjaponol D are achieved by this type II [3 + 2] annulation reaction.

Stereuins A-F: Isopentenyl benzene congeners with antibacterial and neurotrophic activities from Stereum hirsutum HFG27.

Cultivation and extraction of the fungus Stereum hirsutum (Willd.) Pers. yielded 12 isopentenyl benzene derivatives, including six previously undescribed derivatives, named stereuins A-F. Their structures were established based on NMR and mass spectroscopy analyses, supplemented by comparison with previously reported data. Stereuins A-C are unique benzoate derivatives containing fatty acid subunits. Stereuins D and E feature a valylene group and a 6/6/6 ring system. In vitro, stereuin A significantly promoted neurite outgrowth. Several compounds exhibited antibacterial activity against Staphylococcus aureus. Stereuin F has an IC50 value of 5.2 µg/mL against S. aureus, comparable to the positive control, penicillin G sodium (1.4 µg/mL).

A novel AI-based diagnostic model for pertussis pneumonia.

It is still very difficult to diagnose pertussis based on a doctor's experience. Our aim is to develop a model based on machine learning algorithms combined with biochemical blood tests to diagnose pertussis. A total of 295 patients with pertussis and 295 patients with non-pertussis lower respiratory infections between January 2022 and January 2023, matched for age and gender ratio, were included in our study. Patients underwent a reverse transcription polymerase chain reaction test for pertussis and other viruses. Univariate logistic regression analysis was used to screen for clinical and blood biochemical features associated with pertussis. The optimal features and 3 machine learning algorithms including K-nearest neighbor, support vector machine, and eXtreme Gradient Boosting (XGBoost) were used to develop diagnostic models. Using univariate logistic regression analysis, 18 out of the 27 features were considered optimal features associated with pertussis The XGBoost model was significantly superior to both the support vector machine model (Delong test, P = .01) and the K-nearest neighbor model (Delong test, P = .01), with the area under the receiver operating characteristic curve of 0.96 and an accuracy of 0.923. Our diagnostic model based on blood biochemical test results at admission and XGBoost algorithm can help doctors effectively diagnose pertussis.

[Clinical Significance of the Levels of Peripheral Blood Tregs and Cytokines IL-35, TGF-ß and IL-10 in Hemophilia A Patients with Fâ § Inhibitor].

OBJECTIVE: To explore the levels of regulatory T cells (Tregs) and cytokines IL-35, TGF-ß and IL-10 in peripheral blood of hemophilia A(HA) patients with FⅧ inhibitor and their clinical significance. METHODS: 43 HA patients admitted to the Hematology Department of the Affiliated Hospital of North China University of Science and Technology from October 2019 to December 2020 were selected, including 6 cases with FⅧ inhibitor and 37 cases without FⅧ inhibitor. In addition, 20 healthy males who underwent physical examinations were selected as healthy controls. Flow cytometry was used to detect the levels of CD4 + CD25 + CD127 - Tregs in peripheral blood of the HA patients and healthy controls, and ELISA assay was used to detect the expression levels of IL-35, TGF-ß and IL-10 in serum, and their differences between different groups were compared. RESULTS: Compared with the healthy control group, the level of Tregs in HA patients was decreased, and the level of Tregs in the FⅧ inhibitor positive group was the lowest, the difference was statistically significant (P <0.05). There was no significant difference in the expression level of Tregs in HA patients of different severity levels. The serum IL-35, TGF-ß, and IL-10 levels in both FⅧ inhibitor negative and positive groups were significantly lower than those in healthy control group, and those in FⅧ inhibitor positive group were significantly lower than those in FⅧ inhibitor negative group (all P <0.05). CONCLUSION: The decrease of Tregs, IL-35, TGF-ß, and IL-10 levels in HA patients may be related to the formation of FⅧ inhibitors.

Structural Simplification of Podophyllotoxin: Discovery of γ-Butyrolactone Derivatives as Novel Antiviral Agents for Plant Protection.

Natural products are a valuable resource for the discovery of novel crop protection agents. A series of γ-butyrolactone derivatives, derived from the simplification of podophyllotoxin's structure, were synthesized and assessed for their efficacy against tobacco mosaic virus (TMV). Several derivatives exhibited notable antiviral properties, with compound 3g demonstrating the most potent in vivo anti-TMV activity. At 500 µg/mL, compound 3g achieved an inactivation effect of 87.8%, a protective effect of 71.7%, and a curative effect of 67.7%, surpassing the effectiveness of the commercial plant virucides ningnanmycin and ribavirin. Notably, the syn-diastereomer (syn-3g) exhibited superior antiviral activity compared to the anti-diastereomer (anti-3g). Mechanistic studies revealed that syn-3g could bind to the TMV coat protein and interfere with the self-assembly process of TMV particles. These findings indicate that compound 3g, with its simple chemical structure, could be a potential candidate for the development of novel antiviral agents for crop protection.

Impact of environmental pollution on ant (Camponotus japonicus) development and labial gland disease.

Metallic pollutants can have harmful impacts on ant morphology and physiology. We studied the occurrence of labial gland disease in Camponotus japonicus from two polluted areas (traffic pollution and industrial pollution) and one non-polluted area. We further analyzed the metal levels (Al, As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb and Zn) and morphological characteristics (head width, body mass, and other morphological traits) of both diseased and healthy workers. Our results showed that labial gland disease was only present in polluted areas, indicating that pollution stress makes ants more vulnerable to infections. Our research revealed that diseased ants in polluted areas accumulate higher levels of metals in their bodies and have lower dry weight and residual body mass compared to healthy ants in non-polluted environments, negatively impacting their development. We evaluated the importance of these elements and found that Cu has the greatest impact on the health risk of C. japonicus. Our study underscores the significant impact of environmental pollution on ant morphology and physiology and raises concerns about the broader ecological implications.

The efficacy of acupuncture for trigeminal neuralgia: an overview of systematic reviews.

Background: Many systematic reviews (SRs) and meta-analysis (MAs) have reported the efficacy of acupuncture treatment for primary trigeminal neuralgia (PTN), but the quality of evidence is unknown and therefore needs to be evaluated comprehensively. Methods: Eight electronic databases were searched from their inception until January 5, 2024. The methodological quality, reporting quality, and risk of bias of the included SRs were assessed by the assessment of multiple systematic reviews 2 (AMSTAR-2), the Risk of Bias in Systematic Reviews (ROBIS) tool, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The quality of evidence for outcome measures was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: We identified 13 SRs/MAs met inclusion criteria. According to the results of the AMSTAR-2, six were rated as critically low quality and seven as low quality. According to ROBIS assessment, 8 SRs/MAs were classified as low risk, and 5 SRs/MAs were found to be high risk. The PRISMA report still has some reporting deficiencies in aspects such as protocol and registration, search strategy, risk of bias, additional analyzes and funding. According to the GRADE system, no high-quality evidence was found, 1 was of moderate quality, 4 were of low quality, and 8 were of critical low quality. Conclusion: Based on the evidence collected, acupuncture shows promise as a treatment for PTN patients. However, it is important to note that the included SRs/MAs generally have low methodological quality and evidence quality. Therefore, caution must be exercised when interpreting this conclusion. To enhance future research in this area, it is recommended to adequately report methodological details and adhere to guidelines for conducting SRs/MAs.Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024499280.

Effects of patient-based self-assessed fatigue intervention on early postoperative ambulation following gynaecological oncology surgery: a randomised controlled non-inferiority trial.

OBJECTIVES: To assess the impact of a patient-based self-assessed fatigue intervention aimed at promoting early postoperative ambulation. DESIGN: Prospective randomised controlled trial. SETTING: Single-centre, conducted at the Obstetrics and Gynaecology Department of the Xiangyang Central Hospital, China. PARTICIPANTS: Eligible were adult patients undergoing elective gynaecologic oncologic surgery. INTERVENTIONS: The intervention group utilised a modified Borg Rating of Perceived Experience (RPE) scale for self-assessment of fatigue levels. The control group followed fixed-activity distance guidelines postoperatively. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the self-reported the time to first flatus postoperatively. Secondary outcomes encompassed the time to first defecation, incidence of moderate-to-severe abdominal distention, ileus, postambulation adverse events (nausea, vomiting and dizziness), patient satisfaction with early ambulation instructions, compliance with early ambulation and average hospital costs and length of stay. RESULTS: Between June 2021 and October 2022, 552 patients were enrolled. The self-assessed fatigue intervention group demonstrated non-inferior the time to first flatus compared with the fixed-activity distance assessment group (25.59±14.59 hours vs 26.10±14.19 hours, pnon-inferiority<0.001). Compliance with activity was higher in the intervention group (49.40% vs 36.02%, p<0.001), although it did not reach 50%. The intervention group also exhibited significantly higher mean hospital costs, length of stay and incidence of moderate-to-severe abdominal distention (p<0.001). CONCLUSIONS: The self-assessed fatigue intervention for early postoperative ambulation in gynaecologic oncology patients shows promise as an effective strategy; however, compliance is suboptimal. An intervention based on mandatory, yet reasonable, fixed-activity distance may represent the most viable current approach. Further research is warranted to confirm these findings. TRIAL REGISTRATION NUMBER: CTR2100046035.