Navigating the Global Landscape of Exercise Interventions for Knee Osteoarthritis: Exploring Evolving Trends and Emerging Frontiers From a Bibliometric and Visualization Analysis Perspective (2011-2022).

OBJECTIVES: This study utilizes visual analysis methods to retrospectively examine the evolution and trends in exercise interventions for knee osteoarthritis (KOA) research from 2011 to 2022. DESIGN: Bibliometric and visualization analysis review. SETTING AND PARTICIPANTS: Using the Web of Science database, the literature search range is from January 1, 2011, to December 31, 2022, with the language specified as English and document type set to Article. METHODS: Visual analysis was used to analyze literature in the field of exercise interventions for KOA, with KOA and exercise interventions as the key search terms. Visualization maps for countries/regions were created using Tableau and Scimago Graphica software. Institutional, author, and keyword visualization maps were drawn using CiteSpace and VOSviewer software. RESULTS: In total, 3137 articles were included in the visual analysis. The United States emerged as the leading country in terms of publication volume and contribution. Moreover, developed countries such as the United States, Australia, United Kingdom, and Canada have established close and stable cooperative relationships. The University of Melbourne stood out as the institution with both the highest publication volume and centrality. At the forefront of research output in this field was Bennell K.L. from the University of Melbourne. The journal with the highest co-citation frequency was Osteoarthritis and Cartilage. The keyword clustering map highlighted an evolution in the field of exercise interventions for KOA, emphasizing 8 key research themes spanning knee osteoarthritis, serum cartilage, osteoarthritis initiative, patellofemoral pain, total knee arthroplasty, exercise-induced hypoalgesia, isometric exercise, and anterior cruciate ligament reconstruction. Burst analysis revealed that older adult was the earliest and most prominent keyword, with contemporary topics such as patellofemoral pain, safety, musculoskeletal disorder, and neuromuscular exercise considered as research hotspots and future directions in this field. CONCLUSIONS AND IMPLICATIONS: The global attention on exercise interventions for KOA research is expanding, emphasizing the importance of strengthened connections among developing countries and collaborative author groups. Recent trends have shifted toward topics such as neuromuscular training, treatment safety, and musculoskeletal disorders, whereas research interest in patellofemoral pain remains unabated. Neuromuscular training for KOA represents the current frontier in this field. Future research should delve into the effects of diverse types of exercise interventions for KOA on neuromuscular injury and recovery, exploring feasibility and safety to formulate personalized exercise plans for patients with KOA.

Exploring the moderated mediation of stress and media use: Social support's impact on anxiety among older adults during the COVID-19 pandemic - Insights from a large-scale cross-sectional study in China.

BACKGROUND: This study aimed to assess the prevalence of anxiety symptoms among the older adults, explore whether stress mediated the association between social support and anxiety symptoms, and investigate whether media use moderated the direct or indirect effects within the mediation model. METHODS: Questionnaires and scales were employed to collect data from 1143 individuals aged 60 years and older across 120 cities in China during the COVID-19 pandemic. The collected information encompassed sociodemographic characteristics, social support, anxiety, stress, and media use. Bivariate correlations were then used to analyze the relationships among the study variables. Finally, the mediation and moderated mediation models were examined using the PROCESS macro for SPSS. RESULTS: During the COVID-19 pandemic, 40.1 % of Chinese elderly experienced anxiety. Social support exhibited a negative correlation with anxiety. And, media use positively influenced both stress and anxiety. Stress partially mediated the relationship between social support and anxiety, with a mediation effect of 50.95 %. Notably, media use moderated the association between social support and anxiety, serving as both an indirect mediator (path a: Social support - Stress: B = 0.071, 95 % CI: 0.022, 0.120) and a direct mediator (path c': Social support - Anxiety: B = -0.066, 95 % CI: -0.111, -0.022). LIMITATIONS: This study used a cross-sectional design, which restricts the ability to infer causal relationships. CONCLUSION: Social support is proven to be a potent alleviator of anxiety among the elderly. Stress partially mediated this relationship, while the indirect and direct impact of this mediation was influenced by media use. BRIEF SUMMARY: This study underscores the heightened anxiety prevalence among Chinese elderly during the COVID-19 pandemic, emphasizing the critical role of social support in mitigating these effects. It discovers that while stress acts as a mediator, media use serves as a significant moderator in this dynamic. These findings advocate for the necessity of bolstering social support networks and encouraging prudent media use to effectively manage anxiety and stress among the elderly, particularly in challenging times like a pandemic.

The mitochondrial quality control system: a new target for exercise therapeutic intervention in the treatment of brain insulin resistance-induced neurodegeneration in obesity.

Obesity is a major global health concern because of its strong association with metabolic and neurodegenerative diseases such as diabetes, dementia, and Alzheimer's disease. Unfortunately, brain insulin resistance in obesity is likely to lead to neuroplasticity deficits. Since the evidence shows that insulin resistance in brain regions abundant in insulin receptors significantly alters mitochondrial efficiency and function, strategies targeting the mitochondrial quality control system may be of therapeutic and practical value in obesity-induced cognitive decline. Exercise is considered as a powerful stimulant of mitochondria that improves insulin sensitivity and enhances neuroplasticity. It has great potential as a non-pharmacological intervention against the onset and progression of obesity associated neurodegeneration. Here, we integrate the current knowledge of the mechanisms of neurodegenration in obesity and focus on brain insulin resistance to explain the relationship between the impairment of neuronal plasticity and mitochondrial dysfunction. This knowledge was synthesised to explore the exercise paradigm as a feasible intervention for obese neurodegenration in terms of improving brain insulin signals and regulating the mitochondrial quality control system.

Empowering mitochondrial metabolism: Exploring L-lactate supplementation as a promising therapeutic approach for metabolic syndrome.

Mitochondrial dysfunction plays a critical role in the pathogenesis of metabolic syndrome (MetS), affecting various cell types and organs. In MetS animal models, mitochondria exhibit decreased quality control, characterized by abnormal morphological structure, impaired metabolic activity, reduced energy production, disrupted signaling cascades, and oxidative stress. The aberrant changes in mitochondrial function exacerbate the progression of metabolic syndrome, setting in motion a pernicious cycle. From this perspective, reversing mitochondrial dysfunction is likely to become a novel and powerful approach for treating MetS. Unfortunately, there are currently no effective drugs available in clinical practice to improve mitochondrial function. Recently, L-lactate has garnered significant attention as a valuable metabolite due to its ability to regulate mitochondrial metabolic processes and function. It is highly likely that treating MetS and its related complications can be achieved by correcting mitochondrial homeostasis disorders. In this review, we comprehensively discuss the complex relationship between mitochondrial function and MetS and the involvement of L-lactate in regulating mitochondrial metabolism and associated signaling pathways. Furthermore, it highlights recent findings on the involvement of L-lactate in common pathologies of MetS and explores its potential clinical application and further prospects, thus providing new insights into treatment possibilities for MetS.

Clinical application of repetitive transcranial magnetic stimulation in improving functional impairments post-stroke: review of the current evidence and potential challenges.

In recent years, the stroke incidence has been increasing year by year, and the related sequelae after stroke, such as cognitive impairment, motor dysfunction, and post-stroke depression, seriously affect the patient's rehabilitation and daily activities. Repetitive transcranial magnetic stimulation (rTMS), as a safe, non-invasive, and effective new rehabilitation method, has been widely recognized in clinical practice. This article reviews the application and research progress of rTMS in treating different functional impairments (cognitive impairment, motor dysfunction, unilateral spatial neglect, depression) after stroke in recent years, and preliminary summarized the possible mechanisms. It has been found that the key parameters that determine the effectiveness of rTMS in improving post-stroke functional impairments include pulse number, stimulated brain areas, stimulation intensity and frequency, as well as duration. Generally, high-frequency stimulation is used to excite the ipsilateral cerebral cortex, while low-frequency stimulation is used to inhibit the contralateral cerebral cortex, thus achieving a balance of excitability between the two hemispheres. However, the specific mechanisms and the optimal stimulation mode for different functional impairments have not yet reached a consistent conclusion, and more research is needed to explore and clarify the best way to use rTMS. Furthermore, we will identify the issues and challenges in the current research, explore possible mechanisms to deepen understanding of rTMS, propose future research directions, and offer insightful insights for better clinical applications.

Understanding the Contribution of Lactate Metabolism in Cancer Progress: A Perspective from Isomers.

Lactate mediates multiple cell-intrinsic effects in cancer metabolism in terms of development, maintenance, and metastasis and is often correlated with poor prognosis. Its functions are undertaken as an energy source for neighboring carcinoma cells and serve as a lactormone for oncogenic signaling pathways. Indeed, two isomers of lactate are produced in the Warburg effect: L-lactate and D-lactate. L-lactate is the main end-production of glycolytic fermentation which catalyzes glucose, and tiny D-lactate is fabricated through the glyoxalase system. Their production inevitably affects cancer development and therapy. Here, we systematically review the mechanisms of lactate isomers production, and highlight emerging evidence of the carcinogenic biological effects of lactate and its isomers in cancer. Accordingly, therapy that targets lactate and its metabolism is a promising approach for anticancer treatment.